Address tobacco use at your facility

For years treatment centers and hospitals have not fully addressed tobacco and its impact on staff, patients and recovery. Policies from the American Society of Addiction Medicine (ASAM); NAADAC, The Association for Addiction Professionals; and the medical associations of the United States and Canada encourage all hospitals, medical schools and addiction treatment services to address nicotine on a par with other chemical dependencies. However, many in our profession have yet to acknowledge, embrace and put into practice these principles and guidelines. For those who do make efforts, anchoring the changes in the culture can prove difficult.

Our organizations must have champions at high leadership levels, including in administration, clinical services, physician practice and nursing, and they must be visible in their support of the effort. Transparency in communications on policy and practice change to staff and the community is needed. Resources must be set aside for staff education and training. Treatment organizations must put equal efforts into support and treatment for patients and staff alike. Ongoing efforts are needed to work against complacency.

Our clients indeed might come to us for treatment for something other than nicotine dependence, but if they smoke they are much more likely to die from smoking than from the alcohol and other drug use for which they initially seek help. Assuming that these individuals do not wish to address their smoking amounts to paternalism. All clients, regardless of their motivational level, need to be offered appropriate treatment.

Greg Seward, MSHCA, LADC-I

Director, Tobacco-Free Initiative

UMass Memorial Medical Center and UMass Medical School

Worcester, Mass.