Brief Report: The Effect of Implementing a Tobacco Treatment Service on Adherence to Evidence-Based Practice in an Inpatient State-Owned Psychiatric Hospital Chizimuzo T. C. Okoli, PhD, MPH, MSN, RN , 1,2 Yazan D. Al-Mrayat, MSN, RN, 1 Barbara Stead, MSW, CSW, ACSW 2 1 University of Kentucky College of Nursing, Lexington, Kentucky 2 Eastern State Hospital, Lexington, Kentucky Background and Objectives: The Centers for Medicare and Medicaid Services (CMS) requires reporting of specific tobacco treatment (TT) measures. We examined compliance to these measures before and after initiation of a specialized TT service in a state-psychiatric hospital. Methods: Using a retrospective analysis, patient records (N ¼ 3669) were examined, using one-way ANOVAs, for changes in rates of tobacco use screening and treatment between September– December 2015 (pre-implementation of CMS requirements), and January–April, May–August, and September–December 2016 (post- implementation of the CMS requirements). Results: We found significant increases, between Sep–Dec 2015 and Sep–Dec 2016, in the rates of tobacco use screening (93.4–95.3%, F [3, 12] ¼ 7.39, p ¼ .005), offering TT counseling (68.1–76.5%, F [1] ¼ 18.59, p ¼ .001) and medications (71.7–76.5%, F [1] ¼ 5.86, p ¼ .032). Conclusions and Significance: Our findings can provide guidance to enhance compliance with TT measures in psychiatric settings. (Am J Addict 2018;XX:1–4) INTRODUCTION Despite significant declines in adult tobacco use prevalence over the past few decades, rates among those with Mental Illnesses (MI) have barely changed in the United States; 1 which leads to a high mortality from tobacco-related illnesses. 2 In addition to better physical health outcomes, successful tobacco treatment (TT) can also improve mental health functioning. 3 Moreover, TT decreases rehospitaliza- tions and reduces the likelihood of leaving against medical advice. 4 However, state-operated/supported psychiatric facil- ities fall short of providing TT for patients. 5 These challenges in state-operated/supported facilities are likely due to differing state policies. In the United States, 31 states do not require mandatory TT in psychiatric facilities; 6 and in 2009, only 26.1% of Joint Commission-accredited behavioral health hospitals possessed a smoke-free campus policy. 7 In response, the Inpatient Psychiatric Facility Quality Report (IPFQR) of the Center of Medicare and Medicaid Services (CMS) was implemented by the Affordable Care Act and the Social Security Act as a pay-for-reporting program. 8 This govern- ment-supported requirement promotes TT in both hospitals with underserved populations and psychiatric facilities. But, few studies have examined the impact of the IPFQR in psychiatric facilities. In January 2016, Eastern State Hospital (ESH), a state- owned and Academic Medical Center-managed psychiatric hospital, began implementing a concerted TT service to enhance compliance with the IPFQR requirements. The purpose of this study was to examine compliance with TT using data from the IPFQR. 8 Specifically, the aim of this study was to examine the changes in TT measures as required by the IPFQR (ie, assessing for tobacco use, providing practical counseling, and providing FDA-approved TT medications), 4 months before (Sep–Dec, 2015) and in 4-month intervals (Jan–Apr, May–Aug, and Sep–Dec, 2016) a year after initiation of the TT services. METHODS Setting In the record review period, ESH had five active inpatient units with a 140-bed capacity. The ESH TT service was comprised of two part-time nurses (one .5 Full-Time Equivalent [FTE] and the other .25 FTE) who provided focused care to patients. At admission, all patients were Received October 21, 2017; revised March 24, 2018; accepted April 14, 2018. Address correspondence to Okoli, Tobacco Treatment and Prevention Division, Tobacco Policy Research Program, University of Kentucky College of Nursing, 315 College of Nursing Building, Lexington, KY 40536-0232. E-mail: ctokol1@uky.edu The American Journal on Addictions, XX: 1–4, 2018 Copyright © 2018 American Academy of Addiction Psychiatry ISSN: 1055-0496 print / 1521-0391 online DOI: 10.1111/ajad.12733 1