Data were obtained from 704 organizations (83.7% response rate), which received a $75 honorarium. These procedures were approved promotion by the Institutional Review Boards of the University of Georgia and the University of Kentucky. Given the substantive focus on sustainability, analyses were restricted to 153 organizations that offered a counseling-based smoking cessation program at baseline (Figure 1). Follow-up data were obtained from 135 administrators (88.2% response rate) in 33 states and the District of Columbia. The average duration between waves of data collection was 2.7 years (SD = 0.6); additional analyses (not shown) indicated that duration was not associated with sustainment of smoking cessation programs. Measures The primary-dependent variable was sustainment of a counseling-based smoking cessation program.

At baseline, administrators indicated whether their organization offered a formal smoking cessation program. Affirmative responses prompted additional questions measuring whether the program included individual and/or group counseling sessions dedicated to smoking cessation. Organizations offering a smoking cessation program with at least one type of counseling were considered baseline adopters. These same items were utilized at follow-up to categorize organizations on sustainment (1 = sustained adopters, 0 = discontinuers). The independent variables were administrators�� attitudes and their reports of organizational barriers regarding smoking cessation, measured at baseline and follow-up. These items appear in Table 1.

A final cultural measure was the administrators�� perception of the percentage of clinical staff who were tobacco users. Table 1. Descriptive Statistics of Substance Use Disorder (SUD) Programs Offering a Counseling-Based Smoking Cessation Program at Baseline To control for organizational structure, these analyses drew upon data collected when programs were initially recruited into the NTCS. Control variables included sample type (publicly funded, TCs, or privately funded sample), location in a health care setting (1 = hospital or community mental health center, 0 = freestanding), ownership (1 = government owned, 0 = privately owned), profit status (1= for profit, 0 = nonprofit), accreditation by the Joint Commission or the Commission on the Accreditation of Rehabilitation Facilities (1 = accredited, 0 = not accredited), and delivery of only outpatient SUD treatment services (1= outpatient only, 0 = not outpatient only).

Organizational size was measured by the number of full-time equivalent employees (FTEs) and was natural log transformed to adjust for skew. Finally, availability of NRT, bupropion-SR, and varenicline was measured at baseline and follow-up. Each variable was dichotomous. Data Analysis In addition to descriptive statistics, paired t tests and Wilcoxon��s sign-rank tests for administrator attitudes Anacetrapib and organizational barriers at baseline and follow-up were calculated.