Representative Qualitative Comments From Directors of New Jersey’s Residential Addiction Treatment Facilities After Implementation of Tobacco-Free Treatment Standards.

Questions	Response
What do you believe has been the most beneficial aspect of the Tobacco and Nicotine Provisions?	“Acknowledgement of nicotine dependence and addressing it as part of client and staff addiction.” “It has raised consciousness that this is a killing addiction and increased awareness of tobacco-caused illnesses.” “Opportunity to experience benefits of a tobacco-free life.” “Tobacco-free policy supports those who are trying to quit.” “Clients and staff stopping or cutting back [their tobacco use].” “Increased self-esteem by showing they can do it.” “Smoke breaks [no longer] interrupt treatment.” “Prompted systematic review of tobacco policies and procedures.”
What do you believe has been the most problematic aspect of the Tobacco and Nicotine Provisions?	“Lack of enforcement by the State has marginalized financially facilities that went tobacco-free.” “Lack of a level playing field.” “Fear of reduced admissions and decreased revenues.” “Making cultural change during initial transition.” “Challenge of developing policies and procedures that integrate tobacco and ensur- ing it is followed.” “Residents not willing to quit smoking; not seeing it as a problem.” “Staff resistance to tobacco-free grounds.” “Smoking staff not providing consistent message.”
What practice or technique have you found to be of the greatest value in successfully integrating tobacco depen- dence treatment into the usual practice at your facility?	“Creating a context suggesting that tobacco is abnormal; not normal in society at large.” “Took steps to prepare and set date.” “The message is this is an addiction and we treat addiction.” “Starting it at admission and continuing it through the entire process.” “Nicotine replacement is key.” “Staff that have quit smoking are a real benefit.” “The practice of not having staff that smoke or smell [of smoke].” “Stages of Readiness for Change Model and motivational interviewing.” “Raising awareness and giving incentives for clean time” “UMDNJ Tobacco Dependence Program’s trainings, services, and materials.”
If it were up to me, this is how I would see tobacco addressed in residential substance abuse treatment programs.	“What is outlined in the Standards now. Tobacco fully integrated and addressed, just like other drugs.” “State should enforce [the] Standards. There are no consequences for noncompli- ance.” “Education, education. Working with Readiness to Change Model. Raise cognitive dissonance.” “More intensive treatment for clients requesting it.” “Mandatory treatment throughout [the] State, with NRT provided for clients and staff, with increased educational trainings.”