Implementation of smoking cessation services in group therapy by substance abuse treatment counselors

Objectives: Although the majority of clients receiving substance abuse treatment also smoke, little is known about how frequently counselors address smoking cessation in the context of group therapy and the factors associated with implementing smoking cessation counseling during group sessions. Methods: Using survey data from 1,813 counselors and partial-proportional odds modeling, this research examines correlates of counselor-level implementation of smoking cessation counseling in group sessions. Results: About 58.3% of counselors reported never conducting group sessions dedicated to smoking cessation, and just 5.5% conducted these sessions very often. More counselors (25.7%) reported that they very often address smoking cessation when it “comes up” during group sessions. The frequency of conducting group sessions dedicated to smoking cessation was positively associated with perceived managerial support, knowledge about the PHS guideline, and beliefs that cessation aids addiction recovery, that cessation is an important treatment issue, and that smoking was not a part of the staff culture. The frequency of addressing smoking when it “came up” in group sessions was positively associated with perceived managerial support, knowledge of the guideline, and belief that cessation aids addiction recovery. Personal smoking was generally not associated with implementation once other covariates were controlled. Conclusions: Relatively few substance abuse treatment counselors conduct group sessions dedicated to smoking cessation, but more counselors address smoking cessation when it “comes up” in group sessions. Building managerial support for smoking cessation services, disseminating the PHS clinical practice guideline more widely, and attempting to improve counselors' beliefs about smoking cessation may increase implementation.