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. Author manuscript; available in PMC: 2012 Apr 1.
Published in final edited form as: Drug Alcohol Depend. 2010 Nov 4;114(2-3):237–241. doi: 10.1016/j.drugalcdep.2010.09.017

Table 2.

Survey Items and Response Codes in Knowledge, Attitudes, Clinician Service and Program Service Scales.

Knowledge
What is your level of agreement or disagreement with the following statements: (1= Strongly disagree, 5= Strongly agree)
   The hazards of smoking have been clearly demonstrated.
   The hazards of second-hand smoke have been clearly demonstrated.
   If someone has been in recovery from alcoholism for less than 6 months, quitting smoking would threaten their sobriety. (R)*
   I am aware of community resources to help people quit smoking.
   I have the required skills to quit smoking.
Attitudes
What is your level of agreement or disagreement with the following statements: (1= Strongly disagree, 5= Strongly agree)
   Clients that smoke in this program want to quit.
   I am concerned about smoking.
   Counseling by a clinician at this program would help me to quit smoking.
   I think it would be helpful for clinicians at this program to make appointments specifically to help me quit smoking.
In your opinion, when is the best point to stop smoking? (R)*
      As soon as treatment begins
      After 6 months of treatment
      After 1 year of treatment
      Never
In the program where you are now, did you want help with quitting smoking? (1= No, 5= Yes)
Should tobacco cessation or treatment to quit smoking be offered to people who smoke in this program? (1= No, 5= Yes)
Clinician Services
What is your level of agreement or disagreement with the following statements: (1= Strongly disagree, 5= Strongly agree)
   My clinician has the required skills to help people in this program quit smoking.
   My clinician has the required skills to help people in this program quit smoking.
In the past month, how frequently did your clinician at this program: (1=Never, 5=Always)
   arrange for a follow-up appointment to discuss quitting smoking
   encourage you to quit smoking completely
   encourage you to use NRT
   encouraged you to reduce smoking to five or fewer cigarettes per day if you have stated that you could not quit
   remind you to not smoke in the presence of infants or children
Program Services
What is your level of agreement or disagreement with the following statements: (1= Strongly disagree, 5= Strongly agree)
   Smoking cessation counseling is an important part of this program’s mission.
   I am aware of community resources to help people quit smoking.
In the program where you are now, were you provided with any of the following:(1= No, 5= Yes)
   advice on how to quit smoking
   a referral to a smoking cessation clinic or specialist
   a group that provides education about smoking
   a support group for people who are trying to quit smoking
   educational material about quitting smoking such as pamphlets
   anything else to help you quit smoking
In the program where you are now: (1= No, 5= Yes)
   is smoking cessation a part of your personal treatment
While in this program, were the benefits of quitting smoking and the risks of smoking discussed with you? (1= No, 5= Yes)
In the program where you are now, were you provided with any of the following to help you quit smoking: nicotine patch (Nicoderm), nicotine gum (Nicorette), Zyban or bupropion, nicotine lozenges, nicotine nasal spray, nicotine inhaler, varenicline (Chantix). (1=No medications at all, 5=at least one medication).
*

(R) indicates reverse coding for these items.