Promising Policies And Practices To Address Tobacco Use By Persons With Mental And Substance Use Disorders

female counselor comforting a man

People with mental and substance use disorders:

  • Are approximately twice as likely as the general population to smoke cigarettes,1
  • Are more likely to die from smoking-related illness than from their mental and substance use disorders (i.e. behavioral health conditions),2,3 and
  • Want to quit smoking and are able to do so successfully, which both reduces their risk of developing smoking-related diseases and may also improve their behavioral health outcomes.4,5,6
Policies and Practices in Behavioral Health Treatment Facilities, United States, 2016 - U.S Mental Health Services Treatment Facilities - 48.6% Had a smoke-free campus, 48.9% screened clients for tobacco use, 37.6% offered tobacco cessation counseling, 25.2% offered nicotine replacement therapy (NRT) and 21.5% offered non-nicotine tobacco cessation medications; U.S Substance Use Disorder Treatment Facilities - 34.5% Had a smoke-free campus, 64.0% screened clients for tobacco use, 47.4% offered tobacco cessation counseling, 26.2% offered nicotine replacement therapy (NRT) and 20.3% offered non-nicotine tobacco cessation medications

State Highlights

New York Implements Tobacco-Free Campus Policies

New York Implements Tobacco-Free Campus Policies

Grant Funding in Oklahoma Changes Systems for Assessing and Addressing Tobacco Use

Oklahoma Awards Grant Funds to Screen for Tobacco Use

Hawaii Trains Treatment Providers to Counsel Clients to Quit

Hawaii Trains Treatment Providers to Counsel Clients to Quit

Texas Provides NRT as Part of a Range of Tobacco Cessation Measures in Mental Health Treatment Settings

Texas Provides Free NRT to Treatment Providers

New York and Oklahoma Make it Easier for Persons with Behavioral Health Conditions to Access Non-Nicotine Cessation Medications

New York’s and Oklahoma’s Medicaid Programs Pay for Medication

Additional State Activities - a photo with a several people joining hands to reach out to help one person.

States Take More Steps to Quit Smoking for Behavioral Health Conditions

  1. Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health (NSDUH), 2008-2015. 2015. Available from: Reports and Detailed Tables From the 2015 National Survey on Drug Use and Health (NSDUH)External.
  2. Schroeder SA, Morris CD. Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. Annual Review of Public Health, 31:297—314, 2010.
  3. Druss BG, Zhao L, Von Esenwein S, Morrato EH, Marcus SC. Understanding Excess Mortality in Persons With Mental Illness: 17-Year Follow Up of a Nationally Representative US Survey. Medical Care; 49(6):599–604, 2011.
  4. Centers for Disease Control and Prevention. Vital Signs Fact Sheet: Adult Smoking Focusing on People With Mental Illness. 2013. Available from: Adult Smoking.
  5. Prochaska JJ, Das S, Young-Wolff KC. Smoking, mental illness, and public health. Annual Review of Public Health, 38:165-185, 2017.
  6. Weinberger AH, Platt J, Esan H, Galea S, Erlich D, Goodwin RD. Cigarette Smoking Is Associated With Increased Risk of Substance Use Disorder Relapse: A Nationally Representative, Prospective Longitudinal Investigation. The Journal of Clinical Psychiatry, 2(78):e152—e160, 2017.
  7. Marynak K, VanFrank B, Tetlow S, et al. Tobacco Cessation Interventions and Smoke-Free Policies in Mental Health and Substance Abuse Treatment Facilities—United States, 2016. Morbidity and Mortality Weekly Report, 67(18):519—523, 2018.