{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:12:08Z","timestamp":1792195928258,"version":"4.4.0"},"reference-count":114,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"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":["PP210003"],"award-info":[{"award-number":["PP210003"]}],"id":[{"id":"10.13039\/100004917","id-type":"DOI","asserted-by":"publisher"}]},{"award":["PP210003"],"award-info":[{"award-number":["PP210003"]}],"id":[{"id":"https:\/\/ror.org\/0003xa228","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R25DA059907"],"award-info":[{"award-number":["R25DA059907"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"award":["R25DA059907"],"award-info":[{"award-number":["R25DA059907"]}],"id":[{"id":"https:\/\/ror.org\/00fq5cm18","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA016672"],"award-info":[{"award-number":["P30CA016672"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"award":["P30CA016672"],"award-info":[{"award-number":["P30CA016672"]}],"id":[{"id":"https:\/\/ror.org\/040gcmg81","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>People with substance use disorders (SUDs) smoke at elevated rates compared to the general population, experience significant health disparities, and are overrepresented in rural and medically underserved areas with limited substance use treatment centers (SUTCs), leading individuals to seek care at medical healthcare centers (MHCs) (i.e., organizations providing comprehensive primary and preventive care). Thus, understanding MHCs\u2019 and SUTCs\u2019 capacity for adoption of tobacco-free workplace programs (TFWPs) that involve tobacco-free workplace policies and tobacco use treatment delivery is vital. Centers were continuously enrolled from August 2021 to January 2024, spanning the official duration and ending of the COVID-19 pandemic. As part of a mixed methods study, healthcare providers (N = 347) from 9 MHCs (n = 173) and 10 SUTCs (n = 174) in Texas were surveyed; 85 providers and clinical managers from a subset of this sample, drawn from 5 MHCs and 7 SUTCs, completed interviews about their perception of resource availability for, and value of, TFWPs. The organizational readiness for change theory guided the development of investigator-generated surveys and interviews focused on assessing the constructs of resource availability for and valuing of TFWPs. Quantitative findings generally revealed similar perceptions on value and resource availability. However, more MHC than SUTC providers endorsed lack of time as a barrier to delivering cessation care (p = 0.006). Qualitative themes included lack of training and resources to build capacity; limited institutional frameworks, policies, and practices; underprioritizing of tobacco cessation treatment; and erroneous assumptions that tobacco use sustains SUD sobriety. Results emphasize that MHCs need shorter intervention strategies, while SUTCs may be poised for longer interventions as supported through greater endorsement by MHC compared to SUTC providers of time as a barrier to deliver cessation care alongside similar perceptions on value and resource availability across both settings (MHCs, SUTCs). Overall, findings reinforce the need to build greater capacity across healthcare settings for patients\u2019 tobacco use treatment.<\/jats:p>","DOI":"10.3390\/ijerph23070898","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:34:44Z","timestamp":1783996484000},"page":"898","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Provider Perspectives on a Tobacco-Free Workplace Program in Healthcare Settings Serving Rural and Medically Underserved Areas of Texas: A Mixed Methods Study on Perceived Resource Availability and Value"],"prefix":"10.3390","volume":"23","author":[{"given":"Abigail E.","family":"Bergey","sequence":"first","affiliation":[{"name":"Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, TX 77030, USA"},{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, McElhinney Hall, 3623 Cullen 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 Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Britton","sequence":"additional","affiliation":[{"name":"Department of Health Initiatives, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3865-1077","authenticated-orcid":false,"given":"Asfand B.","family":"Moosa","sequence":"additional","affiliation":[{"name":"Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, TX 77030, 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, McElhinney Hall, 3623 Cullen Blvd., Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7978-8050","authenticated-orcid":false,"given":"Tarik D.","family":"Goulbourne","sequence":"additional","affiliation":[{"name":"Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, TX 77030, USA"},{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, McElhinney Hall, 3623 Cullen Blvd., Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5639-2646","authenticated-orcid":false,"given":"Ammar D.","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, TX 77030, USA"},{"name":"School of Medicine, University of California\u2014San Francisco, 533 Parnassus Ave, San Francisco, CA 94143, 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":"Kathleen","family":"Casey","sequence":"additional","affiliation":[{"name":"Integral Care, 1430 Collier St., Austin, TX 78704, 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 Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,12]]},"reference":[{"key":"ref_1","unstructured":"National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health (2014). 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