Treatment Barrier in Overdose Crisis: A Critical Participatory Action Study of an Inpatient Smoking Ban

Abstract: Objective: Amidst a national overdose epidemic some have expressed concerns that smoking bans in substance use treatment facilities could be a barrier to treatment. After the enactment of a smoking ban on treatment facilities in Philadelphia, university researchers partnered with a local syringe exchange to examine the impact of the ban on people with substance use disorders who were cigarette smokers. Methods: Utilizing a critical participatory action research approach, researchers used a convenience sample to access this hard-to-reach population through the syringe exchange and the organization’s Facebook page. A sample of 112 individuals, including 80 men and 32 women completed an online survey asking about their utilization of inpatient treatment and the role of the smoking ban on entering treatment as well as leaving treatment early. Results: Forty-four percent of respondents said that smoking had been a factor in past decisions about entering treatment and 50% said it would be a factor in future decisions. Of those who left inpatient treatment early, 85% said that smoking was a factor. University and community researchers used this data to help overturn the smoking ban at inpatient substance use treatment facilities. Conclusions: Smoking bans in inpatient facilities may serve as a deterrent to entering treatment and may contribute to individuals leaving treatment early. Results from this study suggest that people with substance use disorders need to be included in policy development regarding smoking restrictions.