Counselor and clinical supervisor perceptions of OASAS tobacco-free regulation implementation extensiveness, perceived accountability, and use of resources.

New York State required substance use disorder (SUD) treatment programs to be 100% tobacco-free in 2008. The current study, part of the CTN platform study Managing Effective Relationships in Treatment Services (MERITS II), examined counselor (N=364) and clinical supervisor (N=98) perceptions of how extensively the tobacco-free regulation was implemented in their treatment programs, perceived accountability for implementing the regulation, and use of OASAS-provided resources to aid implementation one year after the regulation went into effect. Results showed that compared to counselors, supervisors perceive greater implementation extensiveness and report using more resources, yet they perceive lower accountability. In addition, whereas perceived accountability is significantly and positively associated with implementation extensiveness perceptions for counselors, the relationship is negative for supervisors. The association between use of resources and implementation extensiveness perceptions is significant and positive for both counselors and supervisors.

Conclusions: Implementation experiences differ between counselors and clinical supervisors, suggesting the importance of tailoring interventions to promote tobacco-free policies in SUD treatment programs. This study adds to the sparse literature on implementation research in SUD treatment, as well as providing a better understanding of the implementation of the OASAS tobacco-free regulation.