Half of mental health facilities and a third of substance abuse treatment facilities have smoke-free campuses

Opportunity to enhance tobacco cessation treatment in these settings

About half of mental health (49%) and a third of substance abuse treatment facilities (35%) reported having smoke-free campuses in the 50 states, Washington, D.C., and Puerto Rico, according to a new report from the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

People with mental and/or substance use disorders are more than twice as likely to smoke cigarettes as people without such conditions, and are more likely to die from a smoking-related illness than from a behavioral health condition. Yet, many individuals are not screened for tobacco use in behavioral health facilities. The study also found that in 2016, nearly 1 in 2 (49 percent) mental health treatment facilities and 2 in 3 (64 percent) substance abuse treatment facilities reported screening patients for tobacco use.

“Too many smokers lack access to proven interventions that could ultimately help them quit smoking,” said Corinne Graffunder, Dr.P.H., director of CDC’s Office on Smoking and Health. “Many people with mental health and substance abuse disorders want to stop smoking and are able to quit, and can do it with help.”

The CDC/SAMHSA report is based on data from the 2016 National Mental Health Services Survey and the 2016 National Survey of Substance Abuse Treatment Services. It appears in today’s Morbidity and Mortality Weekly Report.

Despite the known benefits of quitting smoking, the provision of tobacco cessation treatment remains limited in behavioral health facilities. Among mental health facilities, 37.6 percent offered tobacco cessation counseling, 25.2 percent offered nicotine replacement therapy (NRT) such as nicotine patches or gum, and 21.5 percent offered non-nicotine cessation medications.

Among substance abuse treatment facilities, 47.4 percent offered tobacco cessation counseling, 26.2 percent offered NRT, and 20.3 percent offered non-nicotine cessation medications.

Wide Variations Exist across States

The percentage of mental health treatment facilities with smoke-free-campus policies ranged from 19.9 percent in Idaho to 77.7 percent in Oklahoma. The percentage of substance abuse treatment facilities with such policies ranged from 10.0 percent in Idaho to 83.0 percent in New York.

Across states, the percentage of mental health treatment facilities offering tobacco cessation counseling ranged from 20.5 percent in Idaho to 68.2 percent in Oklahoma. In substance abuse treatment facilities, the percentage ranged from 26.9 percent in Kentucky to 85.0 percent in New York.

“Helping people with behavioral health conditions quit smoking is a win-win,” said Doug Tipperman, SAMHSA’s Tobacco Policy Liaison. “Quitting smoking reduces the risk of smoking-related diseases and could also improve mental health and addiction recovery outcomes.

Practical Steps

The report notes that several steps to address barriers to making tobacco dependence treatment part of behavioral health treatment, including:

• Removing administrative and financial barriers to delivery of cessation interventions.
• Integrating tobacco screening and treatment protocols into facilities’ workflows and electronic health record systems.
• Providing outreach to behavioral health providers who could emphasize that patients can benefit from evidence-based cessation treatments, although longer duration or more intensive cessation treatments might be needed.

More than 50 years since the landmark first Surgeon General’s Report linked cigarette smoking to lung cancer, smoking remains the leading cause of preventable death and disease in the United States, killing nearly half a million Americans every year. Smoking-related diseases cost Americans nearly $170 billion a year in direct health care expenses.

CDC’s Tips From Former Smokers® campaign features Rebecca, who struggled with depression. Rebecca finally quit smoking after getting care for her depression. For more information on the campaign, including profiles of the former smokers, links to the ads, and free quit help, visit www.cdc.gov/tips.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

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