Abstract
BackgroundWithin alcohol and other drug (AOD) services, staff attitudes and beliefs are important influences determining provision of smoking cessation care. This study of AOD staff aimed to examine: a) current attitudes toward smoking cessation care; b) service and staff characteristics associated with unsupportive smoking cessation care attitudes, and c) perceived barriers to providing smoking cessation care.MethodsBetween July-October 2014, 506 staff from 31 Australian AOD services completed an online cross-sectional survey which assessed agreement with 6 attitudinal statements (supportive and unsupportive) and 10 perceived barriers to smoking cessation care in the AOD setting. Logistic regressions examined service (sector) and staff (age, gender, smoking status and number of years in AOD field) characteristics associated with unsupportive smoking cessation care attitudes.ResultsA large proportion agreed with supportive statements: Smoking cessation care should be part of usual care (87%), smoking cessation care is as important as counselling about other drugs (72%) and staff have the organisational support to provide smoking cessation care (58%). Some respondents agreed with unsupportive statements: AOD clients are not interested in addressing their smoking (40%), increasing smoking restrictions would lead to client aggression (23%), smoking is a personal choice and it is not the service’s role to interfere (16%). Respondents from non-government managed services, current tobacco smokers (compared to ex-smokers) and those with less AOD experience had higher odds of agreeing with unsupportive smoking cessation care statements. The most frequently identified barriers to providing smoking cessation care were: client inability to afford cessation medicines, insufficient funding and lack of a coordinated treatment approach (all 61%).ConclusionsOverall, staff hold largely supportive smoking cessation care attitudes but perceive a large number of barriers to providing smoking cessation care.
Highlights
Within alcohol and other drug (AOD) services, staff attitudes and beliefs are important influences determining provision of smoking cessation care
Recognising the importance of reducing tobacco smoking harms in clients engaged in AOD treatment, national clinical practice guidelines in the US [6], UK [7, 8] and Australia [9] recommend the delivery of evidencedbased smoking cessation care as part of usual care
Identified unsupportive AOD staff attitudes to smoking cessation care include: beliefs about smoking cessation compromising treatment goals for other substances [14]; tobacco dependence being a lower treatment priority than addiction to other substances [15]; clients not willing or interested in addressing their tobacco smoking [16]; and the belief that aggression towards staff will increase if tobacco smoking is addressed [14]
Summary
Within alcohol and other drug (AOD) services, staff attitudes and beliefs are important influences determining provision of smoking cessation care. Tobacco smoking rates in alcohol and other drug (AOD) treatment services are as high as 87% [1, 2]. Recognising the importance of reducing tobacco smoking harms in clients engaged in AOD treatment, national clinical practice guidelines in the US [6], UK [7, 8] and Australia [9] recommend the delivery of evidencedbased smoking cessation care as part of usual care. Identified unsupportive AOD staff attitudes to smoking cessation care include: beliefs about smoking cessation compromising treatment goals for other substances [14]; tobacco dependence being a lower treatment priority than addiction to other substances [15]; clients not willing or interested in addressing their tobacco smoking [16]; and the belief that aggression towards staff will increase if tobacco smoking is addressed [14]
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