Integrating tobacco cessation interventions in behavioral health treatment facilities could decrease tobacco-related disease and death and improve outcomes for patients with mental and substance abuse disorders, according to research published in the Morbidity and Mortality Weekly Report.
People with mental or substance abuse disorders are more than 2 times as likely to smoke cigarettes as people without these disorders and are more likely to die from tobacco-related illnesses than from behavioral health conditions. Many people with behavioral health conditions are able and want to quit smoking.
Researchers from the Centers for Disease Control and Prevention (CDC) and CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA) analyzed data from the 2016 National Mental Health Services Survey and the 2016 National Survey of Substance Abuse Treatment Services to assess tobacco-related policies in mental health and substance abuse facilities. Data from 12,136 mental health and 14,263 substance abuse treatment facilities showed that fewer than half of the facilities in the United States offer evidence-based tobacco cessation treatment. Among mental health facilities, 49% screened patients for tobacco use, 38% offered tobacco cessation counseling, and 49% had smoke-free campuses. Corresponding rates for substance abuse facilities were 64%, 47%, and 35%, respectively.
The limitations of the study include that the data were self-reported by facility personnel and may be subject to bias; that the research was conducted at a facility level rather than at a patient level, with all facilities being counted equally; and that the use of cessation treatments or implementation of smoke-free policies could not be assessed.
These facilities are important settings for interventions and there are opportunities to improve tobacco cessation treatment. Researchers suggest removing administrative and financial barriers to cessation interventions, integrating tobacco screening in facility protocols, and conducting outreach to behavioral health providers, emphasizing the benefits of evidence-based cessation treatments for patients. “Providing barrier-free access to proven cessation treatments [is] critical to reduce smoking-related disease and death in the United States,” the researchers concluded.
Marynak K, VanFrank B, Tetlow S, et al. Tobacco cessation interventions and smoke-free policies in mental health and substance abuse treatment facilities – United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(18):519-523.