Table 4.

.Perceived Negative Consequences of Office of Alcoholism and Substance Abuse Services Regulation: Clinical Supervisors

Category	N	%	n	%	Sample comment
Addict behaviors	32	34.4
Sneakiness			19	20.4	“Client and staff have been forced to engage in sneaky behaviors”
					“Encourages clients to lie which is absolutely not a good thing in terms of their recovery on life in general”
Unauthorized smoking			9	9.7	“More smoking indoors”
					“The clients will now go to unauthorized areas”
Underground economy			4	4.3	“The regulation has created an underground economy around tobacco use”
Enforcement problems	16	17.2
Difficulty enforcing/penalizing			10	10.8	“Not enough staff to monitor violations”
					“Uneven enforcement”
Policing/time lost			6	6.5	“Employees spend quite a bit of time policing the grounds”
Reduces patient census	13	14.0
Fewer patients seeking treatment			6	6.5	“Some clients won’t come into treatments inpatient because they can’t smoke”
Voluntarily leaving treatment			4	4.3	“Many patients have been unable to tolerate a smoke free environment and have left AMA [Against Medical Advice]”
Involuntary discharge			3	3.2	“Clients were being discharged for smoking when they still need treatment”
Negative attitudes	11	11.8
Negative emotional reactions			8	8.6	“Staff and client morale has decreased”
Stigmatization of smokers			3	3.2	“Shame-more-shame”
Compromises treatment goals	9	9.7
Interferes with drug treatment			6	6.5	“Client success rates have declined significantly”
Resistance to treatment			3	3.2	“We have more resistance in the program”
Negative patient behavior	8	8.6
Acting out			8	8.6	“Dealing with ‘acting out’ behaviors”
Miscellaneous	4	4.3			“Fires have started”

Note. Total N = 93. Percentages may not equal 100% due to rounding.