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Substance Use




While 14% of the adult U.S. population smokes, these rates are 2-4 times higher for patients with psychiatric or substance use disorders (Kalman 2005). Patients with substance use disorders want to quit, and they can successfully quit if they receive evidence-based interventions tailored to their needs (Kalman 2010). Contrary to the belief that tobacco cessation will hinder treatment, it actually enhances mental health and non-nicotine substance use treatment outcomes (Lemon 2003, McKelvey 2017). Consequently, efforts should be made to integrate nicotine dependence treatment into substance use treatment through multilevel (clinical, program, and system) changes (Baca and Yahne 2009Prochaska 2004). Taking Texas Tobacco Free (TTTF) is a multicomponent, tobacco free workplace program that expanded in 2017 to work with substance use treatment centers and community agencies serving clients enrolled in substance use treatment. TTTF helps centers build their capacity to treat tobacco dependence among clients with substance use disorders.

Starting in 2021, TTTF was further expanded to serve priority groups from rural and/or medically underserved areas (MUA), who often experience elevated rates of tobacco use and limited access to smoking cessation services (Lasser 2000). To fully address rural and MUA tobacco use, TTTF has a planned expansion into systems and places that already provide healthcare to these priority populations - namely, Federally Qualified Health Centers (where treatment of substance use disorders typically occurs in these areas) and surrounding substance use treatment centers (Rosen 2010, Fiore 2008, MACPAC 2017). In doing so, TTTF aspires to further our mission of preventing cancers among Texans by providing targeted reach and interventions for reducing tobacco use.

Substance Use Disorder Treatment Centers & Community Outreach Agencies that We Worked With


Substance Use Disorder Treatment Centers

Cohort 1:

1.   Sobering Center

2.   Land Manor, Inc.

3.   CARS Methadone – Corpus Christi

4.   STEP Med

5.   Axcel Treatment & Recovery

6.   Crossroads of Fort Worth

7.   Volunteers of America – Riverside

8.   Volunteers of America

9.   Alpha Home

​10. CARS Methadone – Tomball

​11. Billy T. Cattan Outreach Center

12. Montrose Center

13. The Council on Recovery

14. Santa Maria Hostel

15. Texas Clinic – Fulton

16. Texas Clinic – Westview

Cohort 2:

1.   L-H Transitional Center

2.   Grace Counseling

3.   Endeavors

4.   Plainview Serenity Center, Inc.

5.   Abilene Recovery Council

Community Outreach Agencies


Foundation Communities

Isolation Centers 1-5


Luke Society Clinic


Arms of Hope – Medina campus


San Antonio Metropolitan Health District

The Village at Incarnate Word


Arms of Hope – Boles Campus

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Lung Cancer Screening 

Health Centers

Mental Health


Training Program

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