Chmitorz, Andrea

Donath, Carolin

Flöter, Stephanie

Gradl, Sabine

Kröger, Christoph

Metz, Karin

Piontek, Daniela

English

Open Access LMU

Effectiveness of a multi-level intervention to improve tobacco policy in alcohol addiction treatment centersAndrea Chmitorz, Dr. Karin Metz, Carolin Donath, Stephanie Flöter, Daniela Piontek, Sabine Gradl, Dr. Christoph Kröger IFT Institut für Therapieforschung, MünchenBACKGROUND and AIMS METHODSSample: Pretreatment: Data of N= 200 employees from 40 alcohol addiction treatment centersInstruments: Tobacco policy was measured by a modified questionnaire, developed from evidence and Background: It was demonstrated that tobacco policy is connected to smoking prevalence in companies and ●Posttreatment: Data of N=184 employees from 38 centers (matching pre-post: N=115) 10 employees were excluded because the center dropped out before posttreatment assessment. recommendations of international guidelines (ENSH, 2003; Fiore et al., 2000; Hopkins et al., 2001; Task Force on Community Preventive Service, 2000; U.S. Department of Health and Human Services, 2000).public buildings. Smoking bans (Fichtenberg and Glantz, 2002) and restrictive structural measures (Serra, Cabezas, Bonfill and Pladevall-Vila, 2000) are very effective in order to reduce  6 employees left the center and were no longer available for assessment. Tobacco policy was devided in seven category groups:smoking.Structual based interventions seem to be an efficient way to increase cessation rates and the multi-●Design: 20 centers(waiting control group)Pretreatment assessment Posttreatment assessment- Smoking restrictions - Smoking-related training of employees- Consequences - Non-smoker protection level intervention is regarded the most promising way. Supported by management and executives, it seems even more successful. (Serra, Cabezas, Bonfill and Pladevall-Vila, 2000)In alcohol addiction treatment centers, individual specific smoking cessation interventions, do not ● (Prä)- Assessment of smokers - Commitment of center- Smoking cessation offers for patientsseem to be effective in the subgroup of smokers (Metz et al., 2006; Prochaska et al., 2004). The implementation of a multi-level intervention and its influence on structual measures and tobacco 40 alcohol addiction treatment centersONE YEAR MULTI-LEVEL INTERVENTIONEach group consists of 5-12 categorial items („yes“, „no“,  „I do not know“), where „yes“ answers were policy has not been investigated in the setting of alcohol addiction treatment centers, so far. 20 centers(intervention Pretreatment counted. In order to make the counted values comparable, they were transformed on a scale from 0 to 100.Aim:► To test the effectiveness of a multi-level intervention to improve tobacco policy in alcohol work-shopPosttreatment assessmentgroup) assessment(Prä)addiction treatment centers.RESULTS3. Differences in changes over time   1. pretreatment assessment 2. posttreatment assessment٭100control group100control group 1416control group80 treatment group 80 treatment group1012 treatment group٭ ٭٭٭٭Scores60 6068٭٭٭ScoresScoresScores40 4024ScoresScores20 20-200restrictionsconsequencescessation offersassessmentemployee trainingnon-smoker protectioncommitment0restrictionsconsequencescessation offersassessmentemployee trainingnon-smoker protectioncommitment-4restrictionsconsequencescessation offersassessmentemployee trainingnon-smoker protectioncommitment* = significant; p<.05Every category in the 1 year multi-level intervention group increased more than * = significant; p<.05 * = significant; p<.05Except from smoking restrictions, there was no significant difference between After intervention, the posttreatment assessment demonstates significant results in the group without interventionexperimental and control group before intervention the category groups: consequeces, assessment, employee training, protection of non-smokers and commitmentDISCUSSION REFERENCESEffect of multi-level intervention: One year of multi-level intervention has a significant positive     influence on tobacco policy.Restrictions: A new questionaire has been used which has to be validated in the future. European Network of smoke-free hospitals, Eds. (2003): smoke-free hospital. European Guideline for smoke-free hospitals. www.whonichtrauchertag.de/ImplguidedtInternet.pdf, 1-26 [01.02.2006]Fichtenberg, C. M., & Glantz, S. A. (2002). Effect of smoke-free workplaces on smoking behaviour: systematic review. British Medical Journal, 325, 188-195.Fiore, M. C., Bailey, W. C., Cohen, S. J. et al. (2000). 5 Systems Interventions: Relevance to Health Care Administrators, Insurers, and Purchasers. In: U.S. Department of Health and Human Services, Eds.: Clinical ●Effects despite political changes at the national level: Despite the recent political improvements, the multi-level intervention had an additional positive effect on the treatment centers‘ tobacco policy. It No representative sample was recruited, only 5 employees per center were assessed.Practice Guideline „Treating Tobacco Use and Dependence“.Hopkins, D. P., Husten, C. G., Fielding, J. E., Rosenquist, J. N., & Westphal, L. L. (2001): Evidence Reviews and Recommendations on Interventions to Reduce Tobacco Use and Exposure to Environmental Tobacco Smoke. American Journal of Preventive Medicine, 20, 67-87.Serra, C., Cabezas, C., Bonfill, X., & Pladevall-Vila, M. (2001). Interventions for preventing tobacco smoking in public places. [Systematic Review] Cochrane Tobacco Addiction Group Cochrane Database of ●●●indicates, that the training itself had an influence on tobacco policy in alcohol addiction treatment centers.Validation of questionnaire: First positive results for the validation of the questionnaire of tobacco policy.The assessed sample of each center in the pre- and posttreatment measurement did not correspond completely. However, it can be assumed, that a well communicated tobacco policy is independent from the respondent.Systematic Reviews. Issue 3. Task Force on Community Preventive Services (2001). Recommendations Regarding Interventions to Reduce Tobacco Use and Exposure to Environmental Tobacco Smoke. American Journal of Preventive Medicine, 20, 10-50.U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Eds. (2000). Strategies for Reducing Exposure to Environmental Tobacco Smoke, Increasing Tobacco-Use Cessation, and Reducing Initiation in Communities and Health Care Systems. U.S. Department of Health and Humans Services.●●Further improvements required: In all categorial groups of tobacco policy, improvements are possible and should be targeted in the future.Metz, K., Kröger, C., Schütz, C., Flöter, Donath, C., Piontek, D., & Gradl, S. (2006, June). Which smoking cessation intervention works for smokers with an alcohol addiction? Poster presented at CPDD & NIDA International Forum, Scottsdale, AZ.Prochaska, J.J., Delucchi, K., & Hall, S.M., 2004. A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. Journal of Substance Abuse Treatment, 72, 1144-1156.●ASAT is funded by a federal grant of the German Ministry of Education and Research ASAT Contact: chmitorz@ift.de, metz@ift.de(01EB0140-0142, 01EB0440-441).BMBF ADDICTION RESEARCH NETWORK SAXONY-BAVARIA

5 Systems Interventions: Relevance to Health Care Administrators, Insurers, and Purchasers. In: U.S. Department of Health and Human Services, Eds.: Clinical Practice Guideline „Treating Tobacco Use and Dependence“.

A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery.

ASAT is funded by a federal grant of the German Ministry of Education and Research ASAT 1156. Contact: chmitorz@ift.de, metz@ift.de ASAT is funded by a federal grant of the German Ministry of Education and Research

Centers for Disease Control and Prevention, Eds.

European Network of smoke-free hospitals, Eds.

Evidence Reviews and Recommendations on Interventions to Reduce Tobacco Use and Exposure to Environmental Tobacco Smoke.

Task Force on Community Preventive Services

Which smoking cessation intervention works for smokers with an alcohol addiction? Poster presented at CPDD & NIDA International Forum,

Effectiveness of a multi-level intervention to improve tobacco policy in alcohol addiction treatment centers

Universität München: Elektronischen Publikationen

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Effectiveness of a multi-level intervention to improve tobacco policy in alcohol addiction treatment centers

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