Measuring Smoking Knowledge, Attitudes and Services (S-KAS) Among Clients in Addiction Treatment

Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, USA.
Drug and alcohol dependence (Impact Factor: 3.42). 11/2010; 114(2-3):237-41. DOI: 10.1016/j.drugalcdep.2010.09.017
Source: PubMed


Addiction treatment programs are increasingly working to address prevalent and comorbid tobacco dependence in their service populations. However at present there are few published measurement tools, with known psychometric properties, that can be used to assess client-level constructs related to tobacco dependence in addiction treatment settings. Following on previous work that developed a staff-level survey instrument, this report describes the development and measurement characteristics of the smoking knowledge, attitudes and services (S-KAS) for use with clients in addiction treatment settings.
250 clients enrolled in residential drug abuse treatment programs were surveyed. Summary statistics were used to characterize both the participants and their responses, and exploratory factor analysis (EFA) was used to examine the underlying factor structure.
Examination of the rotated factor pattern indicated that the latent structure was formed by one knowledge factor, one attitude factor, and two "service" factors reflecting program services and clinician services related to tobacco dependence. Standardized Cronbach's alpha coefficients for the four scales were, respectively, .57, .75, .82 and .82.
The proposed scales have reasonably good psychometric characteristics, although the knowledge scale leaves room for improvement, and will allow researchers to quantify client knowledge, attitudes and services regarding tobacco dependence treatment. Researchers, program administrators, and clinicians may find the S-KAS useful in changing organizational culture and clinical practices related to tobacco addiction, help in program evaluation studies, and in tracking and improving client motivation.

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Available from: Barbara Tajima, Dec 04, 2015
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    • "The results from this study demonstrated that the majority of patients who participated in the survey were current smokers and that they have substantial ETS exposure across several environments. This is consistent with previous literature demonstrating high rates of smoking (75–97%) among individuals with SUDs (see Guydish et al., 2011; Kalman, 1998; Nahvi et al., 2006; Pajusco et al., 2012). However, these findings are discouraging as high ETS exposure rates were found among study participants. "
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    ABSTRACT: Introduction: Environmental Tobacco Smoke (ETS) has been linked to numerous health problems. While research has demonstrated high prevalence of tobacco use among individuals receiving treatment for substance use disorders (SUDs), no studies have examined ETS among individuals receiving treatment for SUDs, paying specific attention to non-smokers who may be at risk for high exposure to ETS. Methods: Participants (N=261) enrolled in outpatient substance abuse treatment completed a survey, in which 14 items were used to quantify ETS exposure and smoking policies across several environments. Results: Among smokers, 85% reported that their significant others also smoked as compared to 15% among non-smokers (χ(2)=6.624, p<.05). A logistic regression examined the characteristics that predicted smoking in the home. The overall model was significant, (χ(2)=36.046, p<.0005) with variables that independently predicted smoking in the home included having less than a high school diploma, being female, and living with a smoker. Income, age, and living with children were not found to be significant. Overall, 42% white collar workers 26% of service workers and 30% of blue collar workers reported no exposure to ETS. Sixty-seven percent of smokers strongly agreed or agreed that the hazards of secondhand smoke have been clearly demonstrated versus 58% of non-smokers. Conclusions: Smokers and non-smokers enrolled in outpatient substance abuse treatment are frequently exposed to ETS at home, work, and in social settings. The dangers of ETS should be addressed among this population through education, smoke-free policies, and cessation resources, with help from their treatment facility.
    Full-text · Article · Jul 2014 · Addictive Behaviors
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    • "Although smoking cessation programs are rarely available, cross-sectional studies have shown that they are more likely to be offered when organizational cultures value smoking cessation (Fuller et al., 2007) and provide training to staff (Knudsen et al., 2010; Richter, Choi, McCool, Harris, & Ahluwalia, 2004). Most previous research on the availability of smoking cessation services in SUD treatment has used cross-sectional designs (Delucchi et al., 2009; Fuller et al., 2007; Guydish et al., 2011; Hahn, Warnick, & Plemmons, 1999; Knudsen et al., 2010; McCool et al., 2005; Richter et al., 2004), with one recent study on the effectiveness of organizational change interventions to promote adoption (Guydish et al., 2012). Guydish and colleagues found that residential treatment programs were able to increase their delivery of nicotine replacement therapy (NRT) and tobacco-related practices after the programs completed a structured change process. "
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    • ", similar to the staff survey, also asked about tobacco-related services the client received while in treatment (Guydish et al., 2010). The four S-KAS scales, each scored from 1 to 5, reflect Knowledge (α = 0.57), Attitudes (α = 0.75) and tobacco-related Clinician Services (α = 0.82) and Program Services (α = 0.82). "
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