{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:27:49Z","timestamp":1792114069401,"version":"4.4.0"},"reference-count":62,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,26]],"date-time":"2021-12-26T00:00:00Z","timestamp":1640476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004917","name":"Cancer Prevention and Research Institute of Texas","doi-asserted-by":"publisher","award":["PP170070"],"award-info":[{"award-number":["PP170070"]}],"id":[{"id":"10.13039\/100004917","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004917","name":"Cancer Prevention and Research Institute of Texas","doi-asserted-by":"publisher","award":["PP210003"],"award-info":[{"award-number":["PP210003"]}],"id":[{"id":"10.13039\/100004917","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P20CA221697"],"award-info":[{"award-number":["P20CA221697"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P20CA221696"],"award-info":[{"award-number":["P20CA221696"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["U54MD015946"],"award-info":[{"award-number":["U54MD015946"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Tobacco use is exceedingly high among individuals receiving care for opioid addiction, but not commonly addressed by clinicians in treatment settings. Taking Texas Tobacco Free (TTTF) is a comprehensive tobacco-free workplace (TFW) program that builds treatment centers\u2019 capacity to address tobacco use with evidence-based tobacco cessation policies and practices. Here, we examine the process and outcomes of TTTF\u2019s implementation within 7 opioid addiction centers. Program goals were structured according to the RE-AIM framework. Pre- and post-implementation data were collected from client facing and non-client facing employees to assess changes in education, training receipt, knowledge, and intervention behaviors, relative to program goals. Centers reported tobacco screenings conducted and nicotine replacement therapy (NRT) delivered through 6 months post-implementation. Overall, 64.56% of employees participated in TTTF-delivered tobacco education, with a 54.9% gain in tobacco control and treatment knowledge (p &lt; 0.0001), and significant increases in exposure to education about tobacco use and harms among individuals with opioid use disorder (p = 0.0401). There were significant gains in clinicians\u2019 receipt of training in 9\/9 tobacco education areas (ps \u2264 0.0118). From pre- to post-implementation, there were mean increases in the use of the 5A\u2019s (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with statistically significant gains seen in NRT provision\/referral (p &lt; 0.0001). Several program goals were achieved or exceeded; however, 100% center participation in specialized clinical trainings was among notable exceptions. One program withdrew due to competing pandemic concerns; all others implemented comprehensive TFW policies. Overall, TTTF may have improved participating opioid treatment centers\u2019 capacity to address tobacco use, although study limitations, including lower post-implementation evaluation response rates, suggest that results require replication in other opioid addiction treatment settings.<\/jats:p>","DOI":"10.3390\/ijerph19010239","type":"journal-article","created":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T01:00:54Z","timestamp":1640566854000},"page":"239","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers"],"prefix":"10.3390","volume":"19","author":[{"given":"Matthew","family":"Taing","sequence":"first","affiliation":[{"name":"Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8310-3077","authenticated-orcid":false,"given":"Vijay","family":"Nitturi","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4312-7258","authenticated-orcid":false,"given":"Tzuan A.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryce","family":"Kyburz","sequence":"additional","affiliation":[{"name":"Integral Care, 1430 Collier Street, Austin, TX 78704, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0073-339X","authenticated-orcid":false,"given":"Isabel","family":"Martinez Leal","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virmarie","family":"Correa-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezemenari M.","family":"Obasi","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Williams","sequence":"additional","affiliation":[{"name":"Integral Care, 1430 Collier Street, Austin, TX 78704, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Casey","sequence":"additional","affiliation":[{"name":"Integral Care, 1430 Collier Street, Austin, TX 78704, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"},{"name":"Department of Health & Human Performance, The University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Litty","family":"Koshy","sequence":"additional","affiliation":[{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Britton","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"Drenner","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7165-5720","authenticated-orcid":false,"given":"Lorraine R.","family":"Reitzel","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,26]]},"reference":[{"key":"ref_1","unstructured":"(2021, January 13). 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