The National Partnership on Behavioral Health and Tobacco Use

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.  This statement led to an overall increase in state efforts to implement state-based policies for behavioral health treatment settings.
• 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.
• VA has implemented smoke-free policies in all VA medical centers for patients, including hospitals, clinics and nursing homes (as of October 2019)
• Public Health Law Center and SCLC conducted surveys with state health representatives across the U.S. in order to compile the number of U.S. State laws requiring tobacco-free grounds for mental health and substance use treatment facilities. This informational chart has been published and available here. PHLC continues work to expand state, local, and provider tobacco-free grounds and cessation integration policies in behavioral health and substance treatment facilities.

Treatment

• Optum developed and implemented a program for smokers with behavioral health conditions. This special offering includes combination NRT, additional coach training and a specialized coach team, connection with a participant’s mental health provider or primary care provider. A pilot study was published in Nicotine and Tobacco Research in 2019 showing that the program increased engagement with treatment and use of NRT. As of March 2020, iterations of this program are available through state quitlines in Maine, Minnesota, Florida, Indiana, North Carolina, South Carolina and Washington and is being promoted by the Partnership.

Communication

• The National Partnership has widely disseminated and promoted two guides developed by SAMHSA, "Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings" and "Implementing Tobacco Cessation Treatment for Individuals with Serious Mental Illness."  In addition to these tools, numerous resources developed by member organizations and other national partners have been promoted by the National Partnership on an ongoing basis.
• Truth Initiative continues its nationwide, digital smoking cessation service, BecomeAnEx, targeting populations still most likely to smoke.
• 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. 

Data

• The smoking prevalence among adults with a behavioral health condition in the United States has been reduced from 34.2% in 2015 to 30.2% in 2018 (Source: NSDUH), nearly surpassing the Partnership’s original target of 30% in 2020. Due to this progress, the Partnership adjusted its target to an ambitious 20% by 2022.
• NAQC is collecting data on the number of adults with behavioral health conditions who smoke and are served by quitlines
• CDC OSH is adding data from N-MMHS and N-SSATS to the OSHData system and creating a State Fact Sheet on Tobacco-related Policies and Practices in Behavioral Health Facilities

Strengthening Strategies

• SCLC has been designated as a National Center of Excellence for Tobacco-Free Recovery by SAMHSA and will continue to hold State Leadership Academy summits as well as provide on-going technical assistance (to reduce smoking prevalence among behavioral health populations in specific states, particularly those in Tobacco Nation) under this banner. SCLC, in partnership with National Behavioral Health Network and SAMHSA, has held Leadership Academy summits in 20 states since 2010.
• With SAMHSA support, two national trainings are being held in August 2020, titled "Creating and Enhancing Tobacco-Free Facilities and Treatment Services," with the purpose of educating behavioral health treatment staff on the importance of addressing tobacco use among their clients and establishing tobacco-free campus policies at their sites.