A randomized clinical trial testing two implementation strategies to promote the treatment of tobacco dependence in community mental healthcare

• Published in: Drug and alcohol dependence 2023-06, Vol.247, p.109873-109873, Article 109873
• Main Authors: Schnoll, Robert A., Leone, Frank T., Quinn, Mackenzie Hosie, Stevens, Nathaniel, Flitter, Alex, Wileyto, Paul, Kimberly, John, Beidas, Rinad S., Hatzell, Jane, Siegel, Scott D., Crawford, Grace, Hill, Naja, Deatley, Teresa, Ziedonis, Douglas
• Format: Article
• Language: English
• Subjects: Humans; Implementation; Mental Health; Mental Health Services; Quality of Life; Tobacco treatment; Tobacco Use - psychology; Tobacco Use Disorder - therapy; Training
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2023.109873

People with serious mental illness (SMI) are more likely to smoke and less likely to receive tobacco treatment. Implementation strategies may address clinician and organizational barriers to treating tobacco in mental healthcare. A cluster-randomized trial (Clinic N=13, Client N=610, Staff N=222) tested two models to promote tobacco treatment in community mental healthcare: standard didactic training vs. Addressing Tobacco Through Organizational Change (ATTOC), an organizational model that provides clinician and leadership training and addresses system barriers to tobacco treatment. Primary outcomes were changes in tobacco treatment from clients, staff, and medical records. Secondary outcomes were changes in smoking, mental health, and quality of life (QOL), and staff skills and barriers to treat tobacco. Clients at ATTOC sites reported a significant increase in receiving tobacco treatment from clinician at weeks 12 and 24 (ps