Virmarie Correa-Fernández, William T. Wilson, Deborah A. Shedrick, Bryce Kyburz, Hannah L. Samaha, Timothy Stacey, Teresa Williams, Cho Y. Lam, Lorraine R. Reitzel

Tobacco-free workplace policies that incorporate evidence-based practices can increase the reach and effectiveness of tobacco dependence treatment among underserved populations but may be underutilized due to limited knowledge about implementation processes. This paper describes the implementation of a comprehensive tobacco-free workplace program at a behavioral healthcare community center in Texas. The center participated in a tobacco-free workplace program implementation project that provided guidance and resources and allowed center autonomy in implementation. Six employee-based subcommittees guided implementation of program components including consumer and staff surveys, policy development, signage, tobacco use assessments, communication, and nicotine replacement distribution. Timeline development, successes, challenges, lessons learned, and sustainability initiatives are delineated. Concerns about the tobacco-free workplace policy from the center’s staff and consumers were gradually replaced by strong support for the initiative. Program success was enabled by consistent support from the center’s leadership, publicity of program efforts, and educational campaigns. The center surpassed the program expectations when it adopted a tobacco-free hiring policy, which was not an initial program goal. This center’s path to a tobacco-free workplace provides an implementation and sustainability model for other behavioral health community centers and other organizations to become tobacco free.


Policy: Contractual agreements requiring behavioral healthcare settings to be tobacco-free are critical first steps in support of tobacco-free environments for patients and staff; however, additional policies need to be implemented and enforced that address integration of tobacco dependence treatment into behavioral healthcare settings as core components of tobacco control and health promotion.

Research: Research is needed to examine specific system- and provider-level factors (e.g., organizational readiness, provider training, administrative support, etc.) that may predict better adoption of tobacco-free workplace policies and improvement in the patient’s health outcomes.

Practice: Behavioral healthcare providers should strive to integrate evidence-based tobacco dependence interventions into the psychiatric treatment of their patients as these interventions have proven safe, effective, and beneficial for this population.

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