Smoking cessation in drug treatment programs.

Substance abusers are more likely to smoke cigarettes than the general population. Yet, in most drug treatment programs smoking cessation receives little attention. The purposes of this study were to: (1) examine substance abuse counselors' attitudes toward and practices related to nicotine addiction and smoking cessation treatment; and (2) describe barriers to smoking cessation treatment and smoking policies in substance abuse treatment facilities. A total of 254 substance abuse counselors in Kentucky completed mailed questionnaires (53% response rate). Almost one-fourth were current smokers. Smoking and nonsmoking counselors differed in their attitudes toward nicotine addiction, barriers to treatment, and satisfaction with smoking cessation training. Few counselors routinely followed the clinical preventive guidelines with nicotine-dependent clients. However, they were receptive to providing smoking cessation treatment. Over half of the drug treatment programs banned indoor smoking, but permitted smoking on facility grounds. Implications for policy change by national addiction certification and licensing organizations and state accreditation authorities are discussed.