Safety Net Provider Attitudes Toward Smoking Cessation Treatment

Lindsay R Meredith; Wave-Ananda Baskerville; Theodore C Friedman; Brian Hurley; Tasha Dixon; Norma Mtume; Luz Rodriguez; Briana Lopez; Susan Hsieh; Lara A Ray

doi:10.3389/fpsyt.2021.744816

Safety Net Provider Attitudes Toward Smoking Cessation Treatment

Front Psychiatry. 2021 Sep 28:12:744816. doi: 10.3389/fpsyt.2021.744816. eCollection 2021.

Authors

Lindsay R Meredith¹, Wave-Ananda Baskerville¹, Theodore C Friedman^{2

3

4}, Brian Hurley^{3

4}, Tasha Dixon⁴, Norma Mtume⁴, Luz Rodriguez⁴, Briana Lopez⁴, Susan Hsieh³, Lara A Ray^{1

5

6}

Affiliations

¹ Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.
² Department of Internal Medicine, Charles R. Drew University, Los Angeles, CA, United States.
³ Los Angeles County Department of Health Services, Los Angeles, CA, United States.
⁴ Friends Research Institute, Cerritos, CA, United States.
⁵ Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, United States.
⁶ Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States.

Abstract

Background: Cigarette smoking, which poses significant health risks, is prevalent among vulnerable populations commonly treated by safety net providers. A large-scale implementation science project on specialty tobacco use treatment was launched within the Los Angeles County Health Agency. The first phase of this study seeks to summarize and compare smoking cessation treatment attitudes of providers at the Department of Health Services (DHS) and Department of Mental Health (DMH). Methods: In total, 467 safety net health care providers (DHS = 322; DMH = 145) completed a survey inquiring about attitudes on smoking cessation treatment consisting of locally developed items and those informed by a scale on readiness for organizational change. Descriptive statistics and non-parametric tests were conducted to examine treatment attitudes for DHS and DMH providers. Results: Between agencies, providers largely reported similar attitudes on smoking cessation treatment and expressed positive beliefs regarding the efficacy of smoking cessation aids. Providers slightly or moderately agreed with being prepared to identify and diagnose tobacco use among patients. DMH providers stated that identification of tobacco use was less in line with their job responsibilities (p < 0.0001) and less strongly agreed that varenicline is effective for smoking cessation (p = 0.003), compared with DHS providers. Conclusions: Providers supported smoking cessation aid efficacy but may benefit from additional training on identification and treatment of tobacco use. These findings support the implementation of specialty tobacco cessation treatment programs with training on medications in safety net health care systems, which has the potential to yield large-scale public health benefits.

Keywords: nicotine; provider attitudes; public health agency; smoking cessation; tobacco use.