Substance abuse treatment counselors and tobacco use: A comparison of comprehensive and indoor-only workplace smoking bans

Introduction: While indoor smoking bans reduce employee tobacco use, less is known about whether comprehensive bans, which prohibit smoking in both indoor and outdoor areas, are associated with lower rates of tobacco use than indoor-only bans. Methods: This study integrated data collected via mailed surveys from 1,910 substance abuse treatment counselors and telephone interviews with 417 administrators of substance abuse treatment organizations. Multinomial logistic regression was used to estimate the associations between counselors' self-reported tobacco use and administrators' reports about organizational smoking bans while controlling for counselors' professional and demographic characteristics. Results: In this sample, 20.3% of counselors were current tobacco users, 47.7% identified as former users, and 32.0% reported never using tobacco products. Only 19.5% of counselors worked in a treatment organization that had a comprehensive smoking ban. The likelihood of being a current tobacco user, compared with being a former user or nonuser, was significantly lower for counselors in organizations with comprehensive bans even after controlling for professional and demographic characteristics. Conclusions: Although relatively few substance abuse counselors worked in treatment organizations with comprehensive bans, such bans may represent a promising direction for tobacco control. Given recent research documenting how tobacco use is negatively associated with the delivery of smoking cessation services by health care workers, additional research on the impact of comprehensive environmental tobacco policies is needed.