Evaluation of an Online, Asynchronous Tobacco Treatment Specialist Training: A Mixed-Methods Analysis of Reach, Perceived Trainee Competency, and Training Quality.

BACKGROUND: Although tobacco use disorder is the most prevalent substance use disorder in the United States and remains the world's leading cause of preventable mortality, health care and social service providers receive little training in how to treat it during their formal education. To enhance access to Tobacco Treatment Specialist (TTS) training, we developed an online, self-paced, asynchronous training paired with a 1-day virtual workshop for skills building and demonstration. METHODS: We calculated the reach of our training based on the counties in which trainees worked. Trainees assessed their perceived competence in comprehensively addressing tobacco use across 11 nationally defined competency areas. They assessed the quality of the course and provided written qualitative feedback on course strengths, weaknesses, and areas for improvement. We calculated descriptive statistics for quantitative data and used descriptive content analysis to summarize qualitative data. RESULTS: Between 2021 and 2024, 371 individuals participated, representing 54% of the counties and 91% of the state's population. Post-training, the proportion of trainees reporting that they met each tobacco treatment competency ranged from 77% to 91%. All trainees met predefined performance criteria on standardized knowledge assessments, despite that most (82%) reported little experience in treating tobacco. Trainees agreed the program met quality standards for online trainings. Trainee work settings were diverse, and most trainees (79.8%) received a scholarship. Qualitative analysis identified skills-building activities, program flexibility, and the self-paced format as key strengths of the program. CONCLUSION: The online TTS program increased state capacity to address tobacco use across multiple settings and geographic regions, demonstrating a scalable, accredited approach to expanding the tobacco treatment workforce. This approach is relevant to other state and regional efforts and has the potential to increase access to evidence-based tobacco treatment interventions. Providing state agency-funded scholarships alongside asynchronous training increased training capacity and expanded geographic reach.