{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:27:50Z","timestamp":1792114070441,"version":"4.4.0"},"reference-count":98,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T00:00:00Z","timestamp":1659657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017640","name":"Department of State Health Services","doi-asserted-by":"publisher","award":["HHS000961900001"],"award-info":[{"award-number":["HHS000961900001"]}],"id":[{"id":"10.13039\/100017640","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017640","name":"Department of State Health Services","doi-asserted-by":"publisher","award":["NU58DP006805"],"award-info":[{"award-number":["NU58DP006805"]}],"id":[{"id":"10.13039\/100017640","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017640","name":"Department of State Health Services","doi-asserted-by":"publisher","award":["R25DA054015"],"award-info":[{"award-number":["R25DA054015"]}],"id":[{"id":"10.13039\/100017640","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Centers for Disease Control and Prevention, National and State Tobacco Control Program","award":["HHS000961900001"],"award-info":[{"award-number":["HHS000961900001"]}]},{"name":"Centers for Disease Control and Prevention, National and State Tobacco Control Program","award":["NU58DP006805"],"award-info":[{"award-number":["NU58DP006805"]}]},{"name":"Centers for Disease Control and Prevention, National and State Tobacco Control Program","award":["R25DA054015"],"award-info":[{"award-number":["R25DA054015"]}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse of the National Institutes of Health","doi-asserted-by":"publisher","award":["HHS000961900001"],"award-info":[{"award-number":["HHS000961900001"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse of the National Institutes of Health","doi-asserted-by":"publisher","award":["NU58DP006805"],"award-info":[{"award-number":["NU58DP006805"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse of the National Institutes of Health","doi-asserted-by":"publisher","award":["R25DA054015"],"award-info":[{"award-number":["R25DA054015"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Houston","award":["HHS000961900001"],"award-info":[{"award-number":["HHS000961900001"]}]},{"name":"University of Houston","award":["NU58DP006805"],"award-info":[{"award-number":["NU58DP006805"]}]},{"name":"University of Houston","award":["R25DA054015"],"award-info":[{"award-number":["R25DA054015"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Tobacco use, and thus tobacco-related morbidity, is elevated amongst patients with behavioral health treatment needs. Consequently, it is important that centers providing health care to this group mandate providers\u2019 use of tobacco screenings to inform the need for tobacco use disorder intervention. This study examined the prevalence of mandated tobacco screenings in 80 centers providing health care to Texans with behavioral health needs, examined key factors that could enhance screening conduct, and delineated providers\u2019 perceived barriers to tobacco use intervention provision. The results indicated that 80% of surveyed centers mandated tobacco use screenings; those that did were significantly more likely than those that did not to have a hard stop for tobacco use status in health records and were marginally more likely to make training on tobacco screening available to providers. The most widespread barriers to tobacco use disorder care provision were relative perceived importance of competing diagnoses, lack of community resources to refer patients, perceived lack of time, lack of provider knowledge or confidence, and belief that patients do not comply with cessation treatment. Overall, the results suggest that there are opportunities for centers providing care to Texans with behavioral health needs to bolster their tobacco screening and intervention capacity to better address tobacco-related health disparities in this group. Health care centers can support their providers to intervene in tobacco use by mandating screenings, streamlining clinical workflows with hard stops in patient records, and educating providers about the importance of treating tobacco with brief evidence-based intervention strategies while providing accurate information about patients\u2019 interest in quitting and providers\u2019 potential impacts on a successful quit attempt.<\/jats:p>","DOI":"10.3390\/ijerph19159647","type":"journal-article","created":{"date-parts":[[2022,8,7]],"date-time":"2022-08-07T22:51:46Z","timestamp":1659912706000},"page":"9647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5639-2646","authenticated-orcid":false,"given":"Ammar D.","family":"Siddiqi","sequence":"first","affiliation":[{"name":"Department of Biosciences, Rice University, 6100 Main St., Houston, TX 77005, USA"},{"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"}]},{"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"}]},{"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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5284-1686","authenticated-orcid":false,"given":"Brian J.","family":"Carter","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":"Carol","family":"Wang","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":"Department of Health Disparities Research, MD Anderson Cancer Center, Houston, TX 77230, 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":"Anastasia","family":"Rogova","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 St., Austin, TX 78704, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Williams","sequence":"additional","affiliation":[{"name":"Integral Care, 1430 Collier St., Austin, TX 78704, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayuri","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of State Health Services, Tobacco Prevention and Control Branch, Austin, TX 78714, 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":[[2022,8,5]]},"reference":[{"key":"ref_1","unstructured":"CDC (2022, June 16). Smoking & Tobacco Use Data and Statistics, Available online: https:\/\/www.cdc.gov\/tobacco\/data_statistics\/index.htm#:~:text=Tobacco%20use%20is%20the%20leading,product%2C%20including%20e%2Dcigarettes."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100349","DOI":"10.1016\/j.ssmph.2019.100349","article-title":"Smoking-Attributable Mortality by Cause of Death in the United States: An Indirect Approach","volume":"7","author":"Lariscy","year":"2019","journal-title":"SSM Popul. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.ypmed.2016.04.008","article-title":"Trends in Tobacco Use among US Adults with Chronic Health Conditions: National Survey on Drug Use and Health 2005\u20132013","volume":"92","author":"Stanton","year":"2016","journal-title":"Prev. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.15585\/mmwr.mm6946a4","article-title":"Tobacco Product Use among Adults\u2014United States, 2019","volume":"69","author":"Cornelius","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1093\/ntr\/ntaa045","article-title":"Advancing Our Understanding of Tobacco Use in Vulnerable Populations","volume":"22","author":"Tidey","year":"2020","journal-title":"Nicotine Tob. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3322\/caac.21444","article-title":"Who\u2019s Still Smoking? Disparities in Adult Cigarette Smoking Prevalence in the United States: Disparities in Adult Smoking Prevalence in the US","volume":"68","author":"Drope","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_7","unstructured":"SAMHSA (2022, June 16). Behavioral Health Treatments and Services, Available online: https:\/\/www.samhsa.gov\/find-help\/treatment."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.amepre.2018.05.024","article-title":"Tobacco Screening and Counseling in the U.S.: Smokers with Mental Health and Substance Use Problems","volume":"55","author":"Samples","year":"2018","journal-title":"Am. J. Prev. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ypmed.2016.05.011","article-title":"A Review of Epidemiologic Research on Smoking Behavior among Persons with Alcohol and Illicit Substance Use Disorders","volume":"92","author":"Weinberger","year":"2016","journal-title":"Prev. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1001\/archpsyc.61.11.1107","article-title":"Nicotine Dependence and Psychiatric Disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions","volume":"61","author":"Grant","year":"2004","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.2105\/AJPH.2013.301232","article-title":"Smokers with Behavioral Health Comorbidity Should Be Designated a Tobacco Use Disparity Group","volume":"103","author":"Williams","year":"2013","journal-title":"Am. J. Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1080\/1462220031000070507","article-title":"Psychiatric Disorders, Familial Factors and Cigarette Smoking: I. Associations with Smoking Initiation","volume":"5","author":"Rohde","year":"2003","journal-title":"Nicotine Tob. Res."},{"key":"ref_13","unstructured":"NIDA (2022, June 16). Do People with Mental Illness and Substance Use Disorders Use Tobacco More Often?, Available online: https:\/\/nida.nih.gov\/publications\/research-reports\/tobacco-nicotine-e-cigarettes\/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often#:~:text=There%20is%20significant%20comorbidity%20between,adults%20with%20no%20mental%20illness."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2606","DOI":"10.1001\/jama.284.20.2606","article-title":"Smoking and Mental Illness: A Population-Based Prevalence Study","volume":"284","author":"Lasser","year":"2000","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1111\/j.1468-0009.2008.00536.x","article-title":"Helping Smokers Quit: Understanding the Barriers to Utilization of Smoking Cessation Services","volume":"86","author":"Gollust","year":"2008","journal-title":"Milbank Q."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1093\/ntr\/ntw146","article-title":"The Difference a Decade Makes: Smoking Cessation Counseling and Screening at Pediatric Visits","volume":"18","author":"Cawkwell","year":"2016","journal-title":"Nicotine Tob. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.amepre.2006.03.011","article-title":"Priorities among Effective Clinical Preventive Services: Methods","volume":"31","author":"Maciosek","year":"2006","journal-title":"Am. J. Prev. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.amepre.2006.03.013","article-title":"Repeated Tobacco-Use Screening and Intervention in Clinical Practice: Health Impact and Cost Effectiveness","volume":"31","author":"Solberg","year":"2006","journal-title":"Am. J. Prev. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1001\/jamainternmed.2015.2391","article-title":"Primary Care Provider-Delivered Smoking Cessation Interventions and Smoking Cessation among Participants in the National Lung Screening Trial","volume":"175","author":"Park","year":"2015","journal-title":"JAMA Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1002\/jhm.536","article-title":"Effect of Clinician Advice and Patient Preparedness to Quit on Subsequent Quit Attempts in Hospitalized Smokers","volume":"5","author":"Shah","year":"2010","journal-title":"J. Hosp. Med."},{"key":"ref_21","first-page":"262","article-title":"Interventions to Facilitate Smoking Cessation","volume":"74","author":"Okuyemi","year":"2006","journal-title":"Am. Fam. Physician"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E132","DOI":"10.5888\/pcd12.140529","article-title":"Tobacco Use Screening and Counseling During Hospital Outpatient Visits among US Adults, 2005\u20132010","volume":"12","author":"Jamal","year":"2015","journal-title":"Prev. Chronic Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ypmed.2016.07.012","article-title":"Providers\u2019 Advice Concerning Smoking Cessation: Evidence from the Medical Expenditures Panel Survey","volume":"91","author":"Kaplan","year":"2016","journal-title":"Prev. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"519","DOI":"10.15585\/mmwr.mm6718a3","article-title":"Tobacco Cessation Interventions and Smoke-Free Policies in Mental Health and Substance Abuse Treatment Facilities\u2014United States, 2016","volume":"67","author":"Marynak","year":"2018","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_25","unstructured":"AAFP (2022, June 16). Coding for Tobacco Screening and Cessation. Available online: https:\/\/www.aafp.org\/family-physician\/patient-care\/care-resources\/tobacco-and-nicotine\/coding-for-tobacco-screening-and-cessation.html."},{"key":"ref_26","unstructured":"KFF (2022, June 16). Data Note: Medicaid\u2019s Role in Providing Access to Preventive Care for Adults. Available online: https:\/\/www.kff.org\/medicaid\/issue-brief\/data-note-medicaids-role-in-providing-access-to-preventive-care-for-adults\/."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1007\/s11606-017-4062-6","article-title":"Disparities in US Healthcare Provider Screening and Advice for Cessation Across Chronic Medical Conditions and Tobacco Products","volume":"32","author":"Keith","year":"2017","journal-title":"J. Gen. Intern. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.amepre.2018.04.015","article-title":"Trends in Healthcare Provider Advice on Youth Tobacco Use, 2011\u20132015","volume":"55","author":"Dai","year":"2018","journal-title":"Am. J. Prev. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.amepre.2019.06.009","article-title":"Tobacco Screening and Treatment of Patients with a Psychiatric Diagnosis, 2012\u20132015","volume":"57","author":"Rogers","year":"2019","journal-title":"Am. J. Prev. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"90","DOI":"10.2105\/AJPH.2013.301584","article-title":"Tobacco Use Screening and Treatment by Outpatient Psychiatrists before and after Release of the American Psychiatric Association Treatment Guidelines for Nicotine Dependence","volume":"104","author":"Rogers","year":"2014","journal-title":"Am. J. Public Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e41","DOI":"10.4278\/ajhp.130820-QUAN-436","article-title":"Screening and Counseling for Tobacco Use in Student Health Clinics: Reports of Health Care Providers","volume":"30","author":"Sutfin","year":"2015","journal-title":"Am. J. Health Promot."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12971-016-0107-6","article-title":"Physician Tobacco Screening and Advice to Quit among U.S. Adolescents\u2014National Survey on Drug Use and Health, 2013","volume":"15","author":"Collins","year":"2017","journal-title":"Tob. Induc. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1097\/JU.0000000000001572","article-title":"Tobacco Screening and Treatment during Outpatient Urology Office Visits in the United States","volume":"205","author":"Bernstein","year":"2021","journal-title":"J. Urol."},{"key":"ref_34","unstructured":"Fiore, M., Ja\u00e9n, C., Baker, T., Bailey, W., Benowitz, N., Curry, S., Dorfman, S., Froelicher, E., Goldstein, M., and Healton, C. (2022, June 16). Treating Tobacco Use and Dependence: 2008 Update. Available online: http:\/\/www.tobaccoprogram.org\/clientuploads\/documents\/Consumer%20Materials\/Clinicians%20Systems%20Mat\/2008-Guidelines.pdf."},{"key":"ref_35","first-page":"38","article-title":"Centers for Disease Control and Prevention (CDC) Tobacco Use Screening and Counseling during Physician Office Visits among Adults--National Ambulatory Medical Care Survey and National Health Interview Survey, United States, 2005\u20132009","volume":"61","author":"Jamal","year":"2012","journal-title":"MMWR Suppl."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"39","DOI":"10.18332\/tpc\/134751","article-title":"Evaluation of Tobacco Screening and Counseling in a Large, Midwestern Pediatric Emergency Department","volume":"7","author":"Merianos","year":"2021","journal-title":"Tob. Prev. Cessat."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1093\/ntr\/ntx204","article-title":"A Qualitative Evaluation of Mental Health Clinic Staff Perceptions of Barriers and Facilitators to Treating Tobacco Use","volume":"20","author":"Rogers","year":"2018","journal-title":"Nicotine Tob. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"766","DOI":"10.17269\/s41997-020-00318-1","article-title":"Impact of Comprehensive Smoking Cessation Training of Practitioners on Patients\u2019 6-Month Quit Outcome","volume":"111","author":"Baliunas","year":"2020","journal-title":"Can. J. Public Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1111\/j.1365-2648.2010.05483.x","article-title":"Training Nurses in the Treatment of Tobacco Use and Dependence: Pre- and Post-Training Results: Training Nurses in the Treatment of Tobacco Dependence","volume":"67","author":"Sheffer","year":"2011","journal-title":"J. Adv. Nurs."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"6","DOI":"10.18332\/tpc\/115033","article-title":"Current practices and perceived barriers to tobacco-treatment delivery among healthcare professionals from 15 European countries. The EPACTT Plus project","volume":"6","author":"Girvalaki","year":"2020","journal-title":"Tob. Prev. Cessat."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1093\/fampra\/cmx137","article-title":"Barriers and Facilitators among Health Professionals in Primary Care to Prevention of Cardiometabolic Diseases: A Systematic Review","volume":"35","author":"Holzmann","year":"2018","journal-title":"Fam. Pract."},{"key":"ref_42","first-page":"419","article-title":"Opportunistic Preventive Services Delivery. Are Time Limitations and Patient Satisfaction Barriers?","volume":"46","author":"Stange","year":"1998","journal-title":"J. Fam. Pract."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"635","DOI":"10.2105\/AJPH.93.4.635","article-title":"Primary Care: Is There Enough Time for Prevention?","volume":"93","author":"Yarnall","year":"2003","journal-title":"Am. J. Public Health"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1146\/annurev.publhealth.012809.103701","article-title":"Confronting a Neglected Epidemic: Tobacco Cessation for Persons with Mental Illnesses and Substance Abuse Problems","volume":"31","author":"Schroeder","year":"2010","journal-title":"Annu. Rev. Public Health"},{"key":"ref_45","first-page":"6","article-title":"Utilization of the Electronic Health Record to Improve Provision of Smoking Cessation Resources for Vascular Surgery Inpatients","volume":"4","author":"Robert","year":"2015","journal-title":"Int. J. Cardiovasc. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.3390\/ijerph10052069","article-title":"It\u2019s Not That Simple: Tobacco Use Identification and Documentation in Acute Care","volume":"10","author":"Smith","year":"2013","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1001\/archinternmed.2010.527","article-title":"Electronic Health Records and Clinical Decision Support Systems: Impact on National Ambulatory Care Quality","volume":"171","author":"Romano","year":"2011","journal-title":"Arch. Intern. Med."},{"key":"ref_48","unstructured":"Texas Almanac (2022, June 16). Texas Population: Still Growing and Increasingly Diverse. Available online: https:\/\/www.texasalmanac.com\/articles\/texas-population-still-growing#:~:text=Although%20Texas%20has%20a%20large,with%2050%2C000%20or%20more%20people."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.ypmed.2017.03.011","article-title":"A Growing Geographic Disparity: Rural and Urban Cigarette Smoking Trends in the United States","volume":"104","author":"Doogan","year":"2017","journal-title":"Prev. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1177\/1524839917696713","article-title":"Addressing Tobacco Use among Consumers and Staff at Behavioral Health Treatment Facilities Through Comprehensive Workplace Programming","volume":"18","author":"Samaha","year":"2017","journal-title":"Health Promot. Pract."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1007\/s13142-017-0476-2","article-title":"Implementation of a Tobacco-Free Workplace Program at a Local Mental Health Authority","volume":"7","author":"Wilson","year":"2017","journal-title":"Behav. Med. Pract. Policy Res."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Taing, M., Nitturi, V., Chen, T.A., Kyburz, B., Martinez Leal, I., Correa-Fern\u00e1ndez, V., Obasi, E.M., Williams, T., Casey, K., and O\u2019Connor, D.P. (2021). Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19010239"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1093\/tbm\/iby067","article-title":"Evaluation of the Taking Texas Tobacco Free Workplace Program within Behavioral Health Centers","volume":"9","author":"Wilson","year":"2019","journal-title":"Transl. Behav. Med."},{"key":"ref_54","first-page":"A73","article-title":"Anxiety Disorders in Primary Care","volume":"59","author":"Shear","year":"1995","journal-title":"Bull Menn. Clin."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1023\/A:1004662600803","article-title":"The Treatment of Anxiety Disorders in a Primary Care HMO Setting","volume":"71","author":"Price","year":"2000","journal-title":"Psychiatr. Q."},{"key":"ref_56","unstructured":"Health Resources & Services Adminiatration (2022, June 16). Federally Qualified Health Centers, Available online: https:\/\/www.hrsa.gov\/opa\/eligibility-and-registration\/health-centers\/fqhc\/index.html."},{"key":"ref_57","unstructured":"HRSA (2022, June 16). Find Your Local Mental Health or Behavioral Health Authority, Available online: https:\/\/www.hhs.texas.gov\/services\/mental-health-substance-use\/mental-health-substance-use-resources\/find-your-local-mental-health-or-behavioral-health-authority."},{"key":"ref_58","unstructured":"University of Houston (2022, June 16). HEALTH Research Institute. Available online: https:\/\/hri.uh.edu\/."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Nitturi, V., Chen, T.A., Martinez Leal, I., Correa-Fern\u00e1ndez, V., Drenner, K., Kyburz, B., Williams, T., Obasi, E.M., Britton, M., and Howard, M. (2021). Implementation and Outcomes of a Train-the-Trainer Program at Behavioral Health Treatment Centers as a Mechanism to Maintain Organizational Capacity to Address Tobacco Use Disorder. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182111635"},{"key":"ref_60","unstructured":"CDC (2022, June 16). Texas Provides NRT as Part of a Range of Tobacco Cessation Measures in Mental Health Treatment Settings, Available online: https:\/\/www.cdc.gov\/tobacco\/disparities\/promising-policies-and-practices\/texas-provides-nrt-tobacco-cessation-measures-in-mht.html."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Le, K., Chen, T.A., Martinez Leal, I., Correa-Fern\u00e1ndez, V., Obasi, E.M., Kyburz, B., Williams, T., Casey, K., Taing, M., and O\u2019Connor, D.P. (2021). Organizational Factors Moderating Changes in Tobacco Use Dependence Care Delivery Following a Comprehensive Tobacco-Free Workplace Intervention in Non-Profit Substance Use Treatment Centers. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph181910485"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1037\/fsh0000658","article-title":"An Epidemic and a Pandemic Collide: Assessing the Feasibility of Tobacco Treatment among Vulnerable Groups at COVID-19 Protective Lodging","volume":"40","author":"Ramclam","year":"2022","journal-title":"Fam. Syst. Health"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Martinez Leal, I., Taing, M., Correa-Fern\u00e1ndez, V., Obasi, E.M., Kyburz, B., Le, K., Koshy, L., Chen, T.A., Williams, T., and Casey, K. (2021). Addressing Smoking Cessation among Women in Substance Use Treatment: A Qualitative Approach to Guiding Tailored Interventions. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18115764"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"820","DOI":"10.5993\/AJHB.44.6.7","article-title":"Adapting and Evaluating Implementation of a Tobacco-Free Workplace Program in Behavioral Health Centers","volume":"44","author":"Leal","year":"2020","journal-title":"Am. J. Health Behav."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1093\/ntr\/ntaa163","article-title":"Organizational Characteristics and Readiness for Tobacco-Free Workplace Program Implementation Moderates Changes in Clinician\u2019s Delivery of Smoking Interventions within Behavioral Health Treatment Clinics","volume":"23","author":"Nitturi","year":"2021","journal-title":"Nicotine Tob. Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"652","DOI":"10.5993\/AJHB.44.5.9","article-title":"Tobacco-Free Workplace Program at a Substance Use Treatment Center","volume":"44","author":"Le","year":"2020","journal-title":"Am. J. Health Behav."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.1016\/j.pec.2019.04.013","article-title":"Tobacco-Related Knowledge Following a Comprehensive Tobacco-Free Workplace Program within Behavioral Health Facilities: Identifying Organizational Moderators","volume":"102","author":"Garey","year":"2019","journal-title":"Patient Educ. Couns."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Le, K., Chen, T.A., Martinez Leal, I., Correa-Fern\u00e1ndez, V., Obasi, E.M., Kyburz, B., Williams, T., Casey, K., Brown, H.A., and O\u2019Connor, D.P. (2021). Organizational-Level Moderators Impacting Tobacco-Related Knowledge Change after Tobacco Education Training in Substance Use Treatment Centers. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18147597"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1056\/NEJMp1115176","article-title":"The Joint Commission\u2019s New Tobacco-Cessation Measures\u2014Will Hospitals Do the Right Thing?","volume":"366","author":"Fiore","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_70","unstructured":"TIME, and Sharples, T. (2022, June 16). Smoking Will Kill 1 Billion People. Available online: http:\/\/content.time.com\/time\/health\/article\/0,8599,1711154,00.html."},{"key":"ref_71","unstructured":"Patagonia Health (2022, June 16). The 5 A\u2019s for Smoking Cessation Interventions. Available online: https:\/\/patagoniahealth.com\/blog\/5-smoking-cessation-interventions\/."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1","DOI":"10.32398\/cjhp.v2iSI.905","article-title":"Public Health Nursing Acceptance of the 5 A\u2019s Protocol for Prenatal Smoking Cessation","volume":"2","author":"Yusem","year":"2004","journal-title":"Calif. J. Health Promot."},{"key":"ref_73","unstructured":"SDHEC (2022, June 16). Tobacco Quitline Data and Information, Available online: https:\/\/scdhec.gov\/health\/tobacco-quitline-data-information#:~:text=Smokers%20who%20receive%20Quitline%20services,compared%20to%20using%20medications%20alone."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"S103","DOI":"10.1016\/j.amepre.2020.06.021","article-title":"Ten Million Calls and Counting: Progress and Promise of Tobacco Quitlines in the U.S","volume":"60","author":"Fiore","year":"2021","journal-title":"Am. J. Prev. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/j.1365-2753.2008.01058.x","article-title":"Training Health Care Providers in the Treatment of Tobacco Use and Dependence: Pre- and Post-Training Results","volume":"15","author":"Sheffer","year":"2009","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1097\/01.mlr.0000173566.01877.ac","article-title":"Primary Care Provider Attitudes Are Associated with Smoking Cessation Counseling and Referral","volume":"43","author":"Meredith","year":"2005","journal-title":"Med. Care"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Brose, L.S., Brown, J., and McNeill, A. (2020). Mental Health and Smoking Cessation\u2014A Population Survey in England. BMC Med., 18.","DOI":"10.1186\/s12916-020-01617-7"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/crj.13096","article-title":"Effectiveness of Smoking Cessation in Smokers with COPD and Nocturnal Oxygen Desaturation: Functional Analysis","volume":"14","author":"Pezzuto","year":"2020","journal-title":"Clin. Respir. J."},{"key":"ref_79","unstructured":"CDC (2022, June 16). Smoking Cessation: Fast Facts, Available online: https:\/\/www.cdc.gov\/tobacco\/data_statistics\/fact_sheets\/cessation\/smoking-cessation-fast-facts\/index.html."},{"key":"ref_80","unstructured":"Partnership to End Addiction (2022, June 16). Smokers May Try Quitting an Average of 30 Times Before They Succeed: Study. Available online: https:\/\/drugfree.org\/drug-and-alcohol-news\/smokers-may-try-quitting-average-30-times-succeed-study\/#:~:text=to%20End%20Addiction-,Smokers%20May%20Try%20Quitting%20an%20Average,Times%20Before%20They%20Succeed%3A%20Study&text=A%20new%20study%20suggests%20smokers,was%20much%20lower%2C%20Reuters%20reports."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/13814788.2022.2092093","article-title":"Cardiovascular Risk Management in Patients with Severe Mental Illness or Taking Antipsychotics: A Qualitative Study on Barriers and Facilitators among Dutch General Practitioners","volume":"28","author":"Jakobs","year":"2022","journal-title":"Eur. J. Gen. Pract."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"891","DOI":"10.3109\/10826084.2014.891615","article-title":"Barriers to Substance Abuse Treatment in Rural and Urban Communities: Counselor Perspectives","volume":"49","author":"Pullen","year":"2014","journal-title":"Subst. Use Misuse"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jsat.2011.10.015","article-title":"Treatment Staff Turnover in Organizations Implementing Evidence-Based Practices: Turnover Rates and Their Association with Client Outcomes","volume":"42","author":"Garner","year":"2012","journal-title":"J. Subst. Abuse Treat."},{"key":"ref_84","unstructured":"AAFB (2022, June 16). Tobacco: Preventing and Treating Nicotine Dependence and Tobacco Use. Available online: https:\/\/www.aafp.org\/about\/policies\/all\/tobacco-preventingtreating.html."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Wiener, R.C., Swager, L.W., Gaydos, M.S., and Morgan, S.K. (2022). Evaluation of a Tobacco Treatment Training Program. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19084435"},{"key":"ref_86","first-page":"1","article-title":"What Are the Perceptions, Experiences, and Behaviors of Health Care Providers After Implementation of a Comprehensive Smoke-Free Hospital Policy?","volume":"5","author":"Luck","year":"2018","journal-title":"Glob. Qual. Nurs. Res."},{"key":"ref_87","first-page":"660","article-title":"Health Care Provider Tobacco Cessation Counseling among Current African American Tobacco Users","volume":"103","author":"Palmer","year":"2011","journal-title":"J. Natl. Med. Assoc."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1200\/JOP.2015.005124","article-title":"Optimizing Tobacco Cessation Resource Awareness among Patients and Providers","volume":"12","author":"Ma","year":"2016","journal-title":"J. Oncol. Pract."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Jansen, A.L., Capesius, T.R., Lachter, R., Greenseid, L.O., and Keller, P.A. (2014). Facilitators of Health Systems Change for Tobacco Dependence Treatment: A Qualitative Study of Stakeholders? Perceptions. BMC Health Serv. Res., 14.","DOI":"10.1186\/s12913-014-0575-4"},{"key":"ref_90","first-page":"CD008743","article-title":"Use of Electronic Health Records to Support Smoking Cessation","volume":"2014","author":"Boyle","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_91","first-page":"335","article-title":"A Demonstration Project for Using the Electronic Health Record to Identify and Treat Tobacco Users","volume":"109","author":"Lindholm","year":"2010","journal-title":"WMJ"},{"key":"ref_92","unstructured":"Harvard Business Review, and Glaser, J. (2022, June 16). It\u2019s Time for a New Kind of Electronic Health Record. Available online: https:\/\/hbr.org\/2020\/06\/its-time-for-a-new-kind-of-electronic-health-record."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1176\/appi.ps.202000816","article-title":"Use of Electronic Health Information Technology in a National Sample of Hospitals That Provide Specialty Substance Use Care","volume":"72","author":"Shields","year":"2021","journal-title":"Psychiatr. Serv."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"32643","DOI":"10.3402\/jchimp.v6.32643","article-title":"Adoption of Electronic Health Records and Barriers","volume":"6","author":"Palabindala","year":"2016","journal-title":"J. Community Hosp. Intern. Med. Perspect."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1136\/amiajnl-2013-001813","article-title":"Overrides of Medication-Related Clinical Decision Support Alerts in Outpatients","volume":"21","author":"Nanji","year":"2014","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"3010","DOI":"10.1002\/cncr.33545","article-title":"Training Oncology Care Providers in the Assessment and Treatment of Tobacco Use and Dependence","volume":"127","author":"Ostroff","year":"2021","journal-title":"Cancer"},{"key":"ref_97","unstructured":"CDC (2022, June 16). Smokefree Policies Reduce Smoking, Available online: https:\/\/www.cdc.gov\/tobacco\/data_statistics\/fact_sheets\/secondhand_smoke\/protection\/reduce_smoking\/index.htm#:~:text=Employees%20who%20worked%20in%20places,places%20that%20allowed%20smoking%20everywhere.&text=A%20smokefree%20workplace%20policy%3A,3.8%25%20among%20employees%20who%20smoke."},{"key":"ref_98","unstructured":"Texas Department of State Health Services (2022, June 16). Texas Primary Care Office (TPCO)\u2014Federally Qualified Health Centers, Available online: https:\/\/www.dshs.texas.gov\/TPCO\/fqhc\/."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/15\/9647\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:04:34Z","timestamp":1760141074000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/15\/9647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,5]]},"references-count":98,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["ijerph19159647"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19159647","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,5]]}}}