New Research: Smoking Related Outcomes and Association with Tobacco-free Policy in Addiction Treatment, 2015-2016


Key Findings:

  • Compared to programs with no such policy, those having tobacco free grounds recorded lower rates of staff and clients smoking together and lower cigarettes per day (CPD) across all treatment types.
  • In the two residential treatment programs where tobacco-free grounds policies were implemented between 2015 and 2016, analysis of smoking-related outcomes showed significantly decreased smoking behavior and increased receipt of tobacco-related services post policy.
  • These findings suggest the potential for tobacco-free grounds policies to impact smoking-related outcomes in addiction treatment programs.


This study assessed changes in smoking-related outcomes in two cross-sectional samples of clients enrolled in addiction treatment and whether tobacco-free grounds policies were associated with smoking-related outcomes.


Clients in 25 programs were surveyed in 2015 (N = 1,176) and 2016 (N = 1,055). The samples were compared on smoking prevalence, cigarettes per day (CPD), thinking of quitting, past year quit attempts, staff and clients smoking together, attitudes towards quitting, and tobacco-related services. Second, programs with (n = 6) and without (n = 17) tobacco-free grounds at both time points were compared on smoking-related outcomes. Last, we examined changes in these measures for two programs that adopted tobacco-free grounds between 2015 and 2016.


There was one difference across years, such that the mean score for the tobacco Program Service scale increased from 2.37 to 2.48 (p = 0.043, effect size = 0.02). In programs with tobacco-free grounds policies, compared to those without, both CPD and the rate of staff and clients smoking together were significantly lower. In the two programs where tobacco-free grounds were implemented during study years, client smoking prevalence decreased (92.5% v. 67.6%, p = .005), the rate of staff and clients smoking together decreased (35.6% v. 4.2%, p = .031), mean CPD decreased (10.62 v. 8.24, p < .001) and mean tobacco services received by clients increased (2.08 v. 3.05, p < .001).


Addiction treatment programs, and agencies responsible for licensing, regulating and funding these programs, should implement tobacco-free grounds policies.