Substance abuse counselors’ implementation of tobacco cessation guidelines.

This CTN platform study assessed the extent of implementation of the Public Health Service tobacco cessation guidelines among a national sample of counselors working in five different types of substance abuse treatment programs. Implementation patterns among counselors were also identified using cluster analysis and considered differences in counselor characteristics based on their cluster membership. Data were obtained from the 2008 Managing Effective Relationships in Treatment Services (MERITS I) project. Counselors (N = 615) working in National Drug Abuse Treatment Clinical Trials Network (CTN) affiliated community treatment programs completed paper-and-pencil surveys. Implementation of the guidelines was inconsistent and selective. Counselors could be grouped into low versus high implementers. What distinguishes the high implementers from the low implementers? More high compared to low worked in methadone maintenance programs, which is similar to previous findings. Additionally, high implementers tended to report greater annual incomes than low implementers, which may be a function of where these counselors are working. For example, counselors with higher incomes may be more likely to work in upscale and state-of-the-art treatment programs, have patients with greater insurance coverage, and have patients who are more involved in and demanding in terms of their treatment. This study adds to the sparse by emerging literature on the implementation of tobacco cessation guidelines in substance abuse treatment programs. Counselors are in a prime position to capitalize on the crucial opportunity for preventing tobacco related deaths, reducing health care costs, and reaching public health goals by routinely integrating these guidelines into their daily practice.