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Linda Rosenberg

Former President and CEO, National Council for Behavioral Health

Tackling Tobacco Use in Substance Use Treatment Settings

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Earlier this year, I shared with you my own struggle with tobacco. I was a smoker for 25 years, despite having witnessed two very close family members die from lung cancer. I knew I was taking a risk each time I lit a cigarette and that I was putting my health, and even my life, at risk. But like many others who use tobacco, my nicotine addiction had a powerful hold on me. When I finally decided to stop smoking, it took me 10 years, filled with unsuccessful attempts, to quit.  This scenario is universal, shared by individuals who abuse drugs and alcohol.

Tobacco use causes more than 400,000 deaths a year, half of which are people with mental illnesses and substance use disorders. In fact, individuals with substance use disorders are more likely to die from a tobacco-related illness than from their addiction to other substances. This is not surprising considering that 34-80% of people who abuse alcohol smoke and 49-98% of people who abuse other drugs smoke, compared to 19.1% of the general population. Essentially, we are treating people for their addictions, helping them on the road to recovery, only to have them die from tobacco-related diseases, like lung cancer, emphysema, and other illnesses.

Despite the fact that smoke-free policies have become commonplace in public areas and healthcare facilities across the U.S., substance use treatment settings lag behind when it comes to implementing efforts to reduce tobacco use. There are many reasons for this, some of which I myself experienced when working in psychiatric hospitals in New York.

“The people we treat don’t want to quit.”

 “They have more pressing issues to deal with.”

“If we go tobacco-free, people will refuse services.”

I’m sure many others worries come to mind, too. But here is what we know and what the current data supports:

The National Council for Mental Wellbeing, in collaboration with the Smoking Cessation Leadership Center and the Behavioral Health and Wellness Program, with support from Pfizer, shares research, evidence-based practices, and success stories from the field to help change views and misconceptions about tobacco use.

Earlier this fall we hosted “Smoking & Addiction Treatment: Debunking the Myths and Becoming Tobacco-Free,” a webinar in which Dr. Laura Martin, medical director at the University of Colorado’s Behavioral Health and Wellness Program, discussed ways substance use treatment providers implement interventions to improve the health of the individuals they serve. She used the Center for Dependency, Addiction, and Rehabilitation as a case study to show how to become tobacco-free and shared her 12 Steps to Success for treatment facilities looking to go tobacco-free. She also wrote 12 Steps to Success: Tobacco Cessation for Your Addiction Treatment Center for the National Council’s Expert Buzz blog.

The 2013 National Council Conference featured two free sessions on tobacco use among individuals with behavioral health disorders. Last year Chad Morris, PhD, and Cindy Morris, PsyD, from the Behavioral Health and Wellness Program ran The Key to Reducing Unnecessary Death and Disability and Meeting Workforce Wellness Demands, both focused on using evidence-based practices to screen for and treat tobacco addiction. You can expect new sessions at the Conference ‘14 in Washington, D.C., May 5-7.

As behavioral health practitioners, we are in the business of recovery. Addressing tobacco can be a cornerstone of services, and the National Council wants to provide you with the information and resources you need to bring this goal to fruition.

I encourage you to share your thoughts, your concerns, or your experiences with us and with your peers by commenting below. Together, we can educate and empower.