What makes substance abuse centers more likely to help patients quit smoking?

Research shows that when people quit tobacco while they are in treatment for substance abuse, they have better outcomes overall. Yet many treatment centers for people with substance abuse disorders, a population that smokes at much higher rates, don’t offer quitting services.

Truth Initiative® researchers examined six years of data on substance abuse treatment centers to determine how many centers offer tobacco cessation services and what makes a center more likely to offer them. They analyzed a sample of more than 94,000 responses to the National Survey of Substance Abuse Treatment Services—an annual survey sent to nearly all substance abuse facility administrators—between 2006 and 2012.

The results, published in the Journal of Substance Abuse Treatment, found an increase in the number of substance abuse treatment facilities offering cessation services from 13 to 65 percent. “This finding suggests some movement toward an integrated approach to focusing on smoking cessation within substance abuse treatment, but more work needs to be done to improve integration,” said Amy Cohn, director of the Truth Tobacco Studies Collaboratory at the Schroeder Institute® for Tobacco Research and Policy Studies and lead author of the study.

Researchers examined facility- and state-level factors that could contribute to the likelihood of offering services and found that public money plays a role. Tax amount per cigarette pack was highly correlated with offering cessation services at substance abuse treatment facilities. Further, the closer state tobacco control expenditures were to Centers for Disease Control and Prevention recommendations, the more likely substance abuse treatment facilities were to offer cessation services.

Results suggest “policies aimed at increasing the distribution of tax revenues to cessation services in substance abuse treatment facilities may offset tobacco-related burden among those with substance abuse problems,” Cohn said.

Other factors strongly linked with offering cessation services include accepting public insurance, being a public facility instead of a private facility and having higher admission rates. Surprisingly, the presence of smoke-free policies, higher state-level adult smoking rates and earmarks (money set aside for substance abuse treatment) were not associated with offering tobacco cessation services.

These findings about factors that are and are not correlated with integrated smoking cessation services in substance abuse treatment facilities “may lead to improved screening, referral and implementation of coordinated care,” Cohn said.