The National Partnership on Behavioral Health and Tobacco Use

Our Purpose

Individuals with mental illness and/or substance use disorders (behavioral health) represent 25% of the Nation’s population, yet they consume 40% of all cigarettes sold in the US. Half a million Americans die each year due to tobacco use – half of which are individuals with a behavioral health condition.

Smokers die 10 years earlier than non-smokers on average (Source: CDC Fast Facts). Recognizing that this epidemic is a social justice issue, the American Cancer Society (ACS) and the Smoking Cessation Leadership Center (SCLC) convened national leaders from tobacco control, public health and the behavioral health sectors to develop a plan that expands and accelerates efforts to combat disparities in smoking prevalence and treatment for those with mental health and/or substance use disorders. Thus, the National Partnership on Behavioral Health and Tobacco Use was born.

Having reached the target of 30% well ahead of schedule – smoking prevalence in the behavioral health population fell to 30.5% in 2017– the National Partnership has now adopted a more ambitious target to reduce smoking rates to 20% by the year 2022.

ACS and SCLC co-hosted a first-of-its-kind, multi-sectoral summit at ACS’s global headquarters in October 2016, where the new national partnership adopted a goal of reducing smoking prevalence in the behavioral health population in the U.S. from 34.2% in 2015 to 30% in 2020. (Source: United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. National Survey on Drug Use and Health, 2017. Research Triangle Park, NC: RTI International [distributor.) The participants included senior leaders of health professional organizations, federal agencies, not-for-profit health organizations, managed health care companies, and experts in behavioral health and tobacco prevention and cessation.

Current Smoking Among Adults (age> 18) with Past Year Behavioral Health (BH) Condition

Baseline: 30.5% (2017) Target: 20% by 2022

The most recent National Survey on Drug Use and Health (NSDUH) shows that the smoking rate among the behavioral health population dropped to 30.5% in 2017. Following release of the promising new data, the Partnership convened its second summit in November 2018 with an expanded roster of 24 members. An ambitious new target, along with specific strategies to reach that ambitious goal, was set to reduce smoking rates to 20% by the year 2022 (“20 by 22”).

Our Strategy

The Partnership’s new action plan consists of multiple strategies in six categories:

Peer Education
Policy Change
Provider Education and Implementation
Systems Change
Communications
Innovation

Each of the 24 participating organizations pledged to undertake specific actions towards achieving the “20 by 22” target, and multiple collaborative activities were planned. The collaborative efforts designed by the Partnership range from trainings, public communications and program implementation, to the issuance of policy statements and educational offerings.

View Action Plan

Examples of Strategic Actions

Policy

The National Association of State Mental Health Program Directors (NASMHPD) adopted a groundbreaking national policy statement strongly recommending that all behavioral health settings be tobacco-free and offer smoking cessation services. The policy applies to all state mental health programs and facilities in the U.S.
HUD implemented a historic rule in July 2018 that created a sweeping smoke-free policy for all public health authority (PHA) locations. This policy eliminated the use of all combustible (burned) tobacco products in all public housing living units, indoor common areas in public housing, and in PHA administrative office buildings. Multiple national partners – including the ACS, the SCLC, the ALA and the NAQC, among others – are collaborating with community health centers, promoting the use of toll-free quitlines and employing other resources to aid residents in quitting. They are also helping to guide and support PHAs and their residents in reinforcing effective community adherence to the new smoke-free standard.

Treatment

Optum developed and implemented the Tobacco Cessation Behavioral Health Program, which utilized a new helpline to support thousands of smokers with reported behavioral health conditions become tobacco-free. The program is now being offered in 4 states (FL, MN, OK, SC) and continues to grow.

Communication

The National Partnership on Behavioral Health and Tobacco Use submitted a joint public comment to the Centers for Medicare and Medicaid Services (CMS), urging the agency to retain two important tobacco measures as quality indicators (TOB-1 and TOB-3). Due to the public comment response, CMS retained the tobacco measure regarding tobacco use at discharge (TOB-3), allowing health professionals to be reimbursed for providing this service – a critical component of ensuring more robust delivery of tobacco treatment services.
The Communications Committee for the National Partnership has put together a campaign with the hashtag #20by22. A general communication packet for the Communications Toolkit explains how this new goal will be achieved. Read the summary statement and the National Partnership Presentation for more information.

Strengthening Strategies

The SCLC, in partnership with the National Council for Behavioral Health and SAMHSA, held Leadership Academy State Strategy Sessions in NJ, PA, SC, KS, and NC, convening state health leaders to strengthen strategies to reduce smoking prevalence among the behavioral health population in their respective states. SCLC was named the National Center of Excellence for Tobacco-Free Recovery by SAMHSA in September 2018.

American Academy of Family Physicians (AAFP)