New York Implements Tobacco-Free Campus Policies

Strategy: Make Behavioral Health Treatment Settings Tobacco-Free

New York Implements Tobacco-Free Campus Policies - photo outside of a sign that states no smoking beyond this point with an office building in the background.

In 2008, New York became the first state to require that all state-funded or state-certified substance use disorder treatment programs (involving over 1,400 programs at the time) prohibit smoking on any property owned or operated by those programs, including outdoor areas.1

The counselors and clinical supervisors reported that, at first, they had some problems with implementing and enforcing the policy. However, policy implementation improved over time.2, 3

Smoke-free Policies in Behavioral Health Treatment Facilities, New York and United States, 2016 - New York has 65.6% of mental health treatment facilities with smoke-free policies compared to 48.6% for the U.S. overall.  New York has 83% of substance use disorder treatment facilities with smoke-free policies compared to 34.5% for the U.S. overall.

About one year after the New York Office of Alcoholism and Substance Abuse Services (OASAS) implemented this policy, counselors and clinical supervisors noted that:

  • Fewer clients were smoking,
  • More clients were aware of the harms related to smoking, and
  • More clients wanted to quit and knew about resources to help them quit.2

New York first addressed smoking at substance use disorder treatment facilities because of OASAS’s interest and readiness, given its knowledge of the linkages between treating nicotine addiction and treating other addictions. After OASAS implemented its policy, the Office of Mental Health decided to take a similar—but not identical—approach to address the burden of tobacco use on its clients. The Office of Mental Health partnered with the State Department of Health Bureau of Tobacco Control to train mental health providers and Department of Health grantees to help mental health facilities adopt and implement tobacco-free campus policies. These policies prohibit the use of all types of tobacco products, including e-cigarettes, on the entire campuses of mental health facilities, including outdoor areas.

Bureau staff report that the tobacco-free campus policies have resulted in social norm change with respect to tobacco use, making it easier for behavioral health providers to screen for tobacco use and help clients quit. Tobacco-free campus policies can reinforce tobacco-free norms and also eliminate exposure to secondhand smoke. To further support efforts by behavioral health providers to address tobacco use, partner agencies in New York created a cross-walk chart summarizing tobacco-related requirements from several behavioral health regulatory agencies. The chart includes each agency’s regulations and recommendations on screening and treating clients (including at discharge), training staff, and adopting tobacco-free campus policies.4

These efforts have likely contributed to recent research findings showing that New York is the state with the highest proportion of substance use disorder treatment facilities that have smoke-free campuses, screen for tobacco use, offer cessation counseling, and offer nicotine replacement therapy.5

References
  1. de Tormes Eby LT, Laschober T. Clinicians’ Perceptions of Implementation Extensiveness of 100% Tobacco Free Practices: A Longitudinal Study of New York State. Journal of Behavioral Health Services & Research, 41(1):50—63, 2013.
  2. de Tormes Eby LT, Sparks TE, Evans E, Selzer JA. A Qualitative Examination of the Positive and Negative Consequences Associated With Going Tobacco-Free in Substance Abuse Treatment: The NY State Experience. Nicotine & Tobacco Research, 14(12):1407—1417, 2012.
  3. de Tormes Eby LT, Laschober TC. Perceived Implementation of the Office of Alcoholism and Substance Abuse Services (OASAS) Tobacco-Free Regulation in NY State and Clinical Practice Behaviors to Support Tobacco Cessation: A Repeated Cross-Sectional Study. Journal of Substance Abuse Treatment, 45(1):83—90, 2013.
  4. Center of Excellence for Health Systems Improvement. Behavioral Health Tobacco Dependence Regulation Crosswalk. Cdc-pdf[PDF – 1 MB]External Accessed March 29, 2018.
  5. Marynak K, VanFrank B, Tetlow S, et al. Tobacco Cessation Interventions and Smoke-Free Policies in Mental Health and Substance Abuse Treatment Facilities—United States, 2016. Morbidity and Mortality Weekly Report, 67(18):519—523, 2018.