The New Center of Excellence for Tobacco-Free Recovery

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As of October 1, 2018, the Smoking Cessation Leadership Center at UCSF has been officially designated by the Substance Abuse and Mental Health Services Administration (SAMHSA) as the Center of Excellence for Tobacco-Free Recovery. This award, which will fund the new Center of Excellence for the next five years, is a culmination of an over decades-long collaboration between the SCLC and SAMHSA, summarized in part by Santhosh et al, 2014. In brief, when SCLC began in 2003 it was aware of the very high rates of smoking among persons with behavioral health conditions, but we were cautioned against trying to change that by veteran smoking cessation experts who warned that the situation was intractable. Beginning in 2007, however, we decided that the issue was too important to ignore, and since that time we have embarked on a set of activities, summarized largely in our 2018 publication. As described in the two referenced articles, this work involved: convening a summit on behavioral health and smoking; working with SAMHSA to provide small grants to behavioral health clinics to augment smoking cessation activities; providing grants and technical assistance to professional societies such as the American Psychiatric Nurses Association, American Psychiatric Association, and American Psychological Association to bolster their smoking cessation activities; convening 18 state summits in collaboration first with SAMHSA and later the National Behavioral Health Network to convene leading state agencies to set targets for reducing smoking among persons with behavioral health conditions and then facilitating the strategies selected to reach those targets; conducting 80 well-attended webinars on various aspects of smoking and behavioral health; and publishing articles in the scientific and lay literature. More recently, in association with the American Cancer Society, we have launched a new National Partnership on Behavioral Health and Tobacco Use, involving more than 20 organizations and pledged to reduce the smoking prevalence among behavioral health populations from 34% to 30% by the year 2020.

At this point, I want to pay tribute to a number of individuals who helped us to get started in this arena. They include Cheryl Healton, the former president of the American Legacy Foundation (now Truth Initiative) who funded our initial efforts; Bob Glover former director of the National Association of State Mental Health Program Directors and his former deputy Gail Hutchings, who helped orient us to what was for the SCLC a new terrain; Terry Cline, the SAMHSA Director under President George W. Bush, who courageously aligned his agency with smoking cessation; and veteran behavioral health smoking cessation clinician/scholars such as John Hughes, Doug Ziedonis, Jill Williams, and colleagues at UCSF including Sharon Hall, Jodi Prochaska (now at Stanford), and Joe Guydish. Subsequently, we had the honor of working with scores of smoking cessation champions in the many organizations—both governmental and private agencies—who have been such stalwart partners and who inspire us every day.

What will the new Center of Excellence do? In partnership with the National Council for Behavioral Health (National Council), it will conduct a variety of activities to reduce the enormous burden that smoking exerts upon the health of those with behavioral health conditions. One important activity will be to continue our hosting of state academies in which leaders of relevant state governmental, clinical, health insurance sector, and advocacy organizations meet to establish a current behavioral health smoking baseline, set smoking reduction levels, and create concrete action and implementation plans. The Center will then provide ongoing technical assistance and oversight to all state and academy participants. In addition, the Center will conduct webinars on tobacco use, cessation, implementation, and tobacco-free policies, marketed through various partners including the National Council. Finally, it will serve as a resource for the field by disseminating relevant information on smoking cessation research, implementation strategies for tobacco-free facilities, opportunities for training, and other salient topics through its website, listserv, social media, publications in medical journals, clinical society newsletters, and professional conference presentations. It will also maintain an active website and “implementation hub” that will be accessible, topical and a go-to site for administrators, clinicians, and policy-makers.

We are grateful to SAMHSA for its support, to those of you who have worked so diligently in this field, and especially to the smokers who bear the burden of combustible cigarette exposure and who seek relief from their use of tobacco. We will welcome suggestions on how to best to serve you all. Please contact us at 877-509-3786, or email at [email protected]. This is an exciting time to be working in tobacco control. Although far too many people still smoke, levels are declining and are at modern lows for both adults and youth. With your help we can accelerate those trends, and thereby improve the health of the public.