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However, tobacco use is not commonly addressed in substance use treatment centers. This study examined how provider beliefs about addressing tobacco use during non-nicotine substance use treatment, provider self-efficacy in delivering tobacco use assessments, and perceived barriers to the routine provision of tobacco care were associated with changes in the delivery of the evidence-based five A\u2019s for smoking intervention (asking, advising, assessing, assisting, and arranging) at the organizational level. The data were from 15 substance use treatment centers that implemented a tobacco-free workplace program; data were collected before and after the program\u2019s implementation. Linear regression examined how center-level averages of provider factors (1) at pre-implementation and (2) post- minus pre-implementation were associated with changes in the use of the five A\u2019s for smoking in substance use treatment patients. The results indicated that centers with providers endorsing less agreement that tobacco use should be addressed in non-nicotine substance use treatment and reporting lower self-efficacy for providing tobacco use assessments at pre-implementation were associated with significant increases in asking patients about smoking, assessing interest in quitting and assisting with a quit attempt by post-implementation. Centers reporting more barriers at pre-implementation and centers that had greater reductions in reported barriers to treatment over time had greater increases in assessing patients\u2019 interest in quitting smoking and assisting with a quit attempt by post-implementation. Overall, the centers that had the most to learn regarding addressing patients\u2019 tobacco use had greater changes in their use of the five A\u2019s compared to centers whose personnel were already better informed and trained. Findings from this study advance implementation science and contribute information relevant to reducing the research-to-practice translational gap in tobacco control for a patient group that suffers tobacco-related health disparities.<\/jats:p>","DOI":"10.3390\/ijerph191911850","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T21:12:53Z","timestamp":1663708373000},"page":"11850","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Organization-Level Factors Associated with Changes in the Delivery of the Five A\u2019s for Smoking Cessation following the Implementation of a Comprehensive Tobacco-Free Workplace Program within Substance Use Treatment Centers"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4206-4179","authenticated-orcid":false,"given":"Cassidy R.","family":"LoParco","sequence":"first","affiliation":[{"name":"Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, 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, and Learning Sciences, University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, 4849 Martin Luther King Blvd., Houston, TX 77204, 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, and Learning Sciences, University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, 4849 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, and Learning Sciences, University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, 4849 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, and Learning Sciences, University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virmarie","family":"Correa-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, 4849 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"}]},{"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, 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