Smoking cessation care provision in Australian alcohol and other drug treatment services: a cross-sectional survey of staff self-reported practices

Introduction: Clinical practice guidelines recommend alcohol and other drug (AOD) services assess client's smoking status and offer smoking cessation care (SCC) to all smokers. The aim of this study was to examine Australian AOD program staff report of recommended SCC practices: assessment and recording of smoking status; and the provision of 9 types of SCC. The study also assessed how the decision to provide SCC is made and the AOD program service and AOD staff characteristics associated with the provision of SCC. Methods: Between July–October 2014, treatment staff from 31 Australian AOD services participated in an online cross-sectional survey. In addition, a site contact at each service was interviewed to gather service related data. Results: Overall, 362 AOD program staff participated (response rate = 57%) and 62% estimated that client smoking status was recorded for the “majority or all” of their clients. About a third (33%) reported that they “always” provide verbal advice to their clients to quit smoking, 18% “always” offered free or subsidized NRT and 16% “always” followed-up to check on client quit progress. Thirty percent reported that the decision to provide SCC was made on a client by client basis and 26% offered SCC only when the client requested assistance. Government-managed services, age and gender of AOD program staff were significantly associated with the provision of SCC. Conclusion: Most AOD program staff report that smoking status is recorded for the majority of their clients however, the frequency with which SCC practices are delivered is low and the decision to provide care is arbitrary.