Smoking among adolescents in substance abuse treatment: A study of programs, policy, and prevalence.

This study, which used the CTN as a platform, was designed to (1): identify smoking policies and interventions in adolescent residential treatment settings; (2) examine the prevalence of smoking among adolescents in these settings; and (3) assess relationships between program-level smoking policies and client-level smoking. The Center for Substance Abuse Treatment funded 17 sites to evaluate the effectiveness of Adolescent and Residential Treatment (ART) programs for substance abuse. To describe program smoking policies and interventions, the authors conducted phone interviews with one key informant at each program (N = 12). A secondary data analysis of baseline data for adolescents (N = 912) entering ART programs was also done to describe client smoking behaviors. All sites had no smoking indoors and 75% of the sites had tobacco-free grounds for adolescents. Forty-two percent provided their youth with nicotine replacement therapy, and 42% provided counseling for smoking cessation. Also, 33% did not allow staff smoking on and off campus. The prevalence of any smoking in the past month was 66%, and 22% of current smokers were daily smokers at admission. Where smoking was allowed on grounds, adolescents more often reported recent smoking.

Smoking behavior is prevalent among adolescents in residential drug treatment, and should be addressed in all such programs through policy implementation and client-level smoking cessation intervention.