The National Partnership on Behavioral Health and Tobacco Use

Healthier, Smoke-free Lives for People with Mental Illnesses and Substance Use Disorders

Who We Are

Originally founded in 2016 by the American Cancer Society and the Smoking Cessation Leadership Center, the National Partnership assembled leaders from the tobacco control/public health and behavioral health sectors to collaborate on developing a comprehensive plan and course of action to address disparities in smoking prevalence and access to treatment in the US for those with mental health and substance use disorders, collectively known as behavioral health conditions.

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 whom are individuals with a behavioral health condition.

Adults who smoke cigarettes 10 years earlier than those who don't smoke 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 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

When the smoking rate among the behavioral health population dropped to 30.5% in 2017, 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”).

The most recent data from our partners at SAMHSA shows that current smoking among adults with a behavioral health condition continues to decrease at a statistically significant level. In 2019, NSDUH data provided by Doug Tipperman shows that 28.9% of adults with any behavioral health condition smoked. This is down from 30% in 2018.

In 2021, NSDUH data provided by SAMHSA shows that 26.8% of adults with any behavioral health condition smoked. Due to DSM-V definitions used beginning in 2020, the data is not directly comparable to previous years -- however the National Partnership still recognizes this as continued progress and a positive step toward eliminating disparities in tobacco dependence in the U.S.

Our Strategy

The Partnership’s 2024/25 action plan consists of multiple strategies in three categories:

Communications and Messaging
Education, Treatment Resources, and Guidelines
Systems and Settings that Engage Priority Populations

Each of the participating organizations pledged to undertake specific actions towards further reducing smoking prevalence among individuals with behavioral health conditions, and multiple collaborative activities were planned. The collaborative efforts designed by the Partnership include an intersectionality toolkit, a publication on partnership model and progress, creating a lived experience board, and drafting public comments.

Partnership Progress

On October 16th and 17th, the Smoking Cessation Leadership Center hosted an in-person reconvening of the National Partnership on Behavioral Health and Tobacco Use (National Partnership) at the University of California, San Francisco. The partnership last reconvened in April 2023. The convening also began by reintroducing SCLC as a backbone organization, with the organization offering writing assistance, IRB support, and administrative coordination when appropriate. The partnership also agreed to move towards a collective impact model, to incorporate a lived experience board, and that the partnership will determine the best short- and long-term methods of achieving collective impact.

During the convening, three thematic areas were proposed and affirmed: Communications and Messaging, Education, Treatment Resources, and Guidelines, and Systems and Settings that Engage Priority Populations. Two additional focus areas the National Partnership engaged with during this convening: intersectionality- oriented curriculum and co-authoring papers.

Communications and Messaging

Partners will create a consolidated set of communications on tobacco use in behavioral health populations to raise awareness and counter misinformation, and disseminate educational resources including a slide deck, documents, and/or flyers. These communication materials will be available to all partners to share and tailor to their organizations and constituents.

Education, Treatment Resources, and Guidelines

Partners will create a “shared voice” of public position statements and available treatment guidelines by highlighting common elements. This shared voice will be used to develop communications, including op-eds or perspective pieces in high impact journals, and create educational opportunities.

Systems and Settings that Engage Priority Populations

Partners will conduct interviews and surveys with key stakeholders to gain insights on intersectionality of justice-involved and the reentry community, quit journeys, and any barriers to treatments that community members or providers encounter within Certified Community Behavioral Health Centers. The findings will be disseminated through a white paper, scientific journal publications, presentations, and infographics as a way to advocate for policy changes and improvements in treatment protocols.

Collective Impact

The partnership agreed to move towards a collective impact model of governing and the partnership will determine the best short- and long-term methods of achieving collective impact. This new model, as described by the Collective Impact Forum, is a “network of community members, organizations, and institutions who advance equity by learning together, aligning, and integrating their actions to achieve population and systems level change." SCLC will continue to offer support for project coordination, tracking progress, as well as research and publication work arising from the projects, and raised the possibility of convening a lived experience board.

All focus areas will incorporate the partnerships’ overarching efforts to build a lived experience advisory board to engage throughout the strategic implementation process, and to establish best DEI practices.