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

counselor comforting a patient

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%26#37; Had a smoke-free campus, 48.9%26#37; screened clients for tobacco use, 37.6%26#37; offered tobacco cessation counseling, 25.2%26#37; offered nicotine replacement therapy (NRT) and 21.5%26#37; offered non-nicotine tobacco cessation medications; U.S Substance Use Disorder Treatment Facilities - 34.5%26#37; Had a smoke-free campus, 64.0%26#37; screened clients for tobacco use, 47.4%26#37; offered tobacco cessation counseling, 26.2%26#37; offered nicotine replacement therapy (NRT) and 20.3%26#37; offered non-nicotine tobacco cessation medications

State Highlights

  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) [PDF – 13.8 MB].
  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.