CDC: Smoking Policies Vary at Treatment Facilities


Nearly half of mental health (49%) and a third of substance abuse treatment facilities (35%) reported having smoke-free campuses in the 50 states, Washington, D.C., and Puerto Rico.

Nearly half of mental health (49%) and a third of substance abuse treatment facilities (35%) reported having smoke-free campuses in the 50 states, Washington, D.C., and Puerto Rico, according to a new report from the CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA), published in the latestMorbidity and Mortality Weekly Report.

People with mental and/or substance use disorders are more than twice as likely to smoke cigarettes as people without such conditions and are more likely to die from a smoking-related illness than from a behavioral-health condition. Yet, many individuals are not screened for tobacco use in behavioral-health facilities. Based on data from the 2016 National Mental Health Services Survey, and the 2016 National Survey of Substance Abuse Treatment Services, the study also found that in 2016, nearly 49% of mental health treatment facilities and 64% of substance abuse treatment facilities reported screening patients for tobacco use.

“Too many smokers lack access to proven interventions that could ultimately help them quit smoking,” said Corinne Graffunder, DrP, director of the CDC’s Office on Smoking and Health, in a statement. “Many people with mental health and substance abuse disorders want to stop smoking and are able to quit and can do it with help.”

Despite the known benefits of quitting smoking, the provision of tobacco cessation treatment remains limited in behavioral-health facilities. Among mental health facilities, 37.6% offered tobacco cessation counseling, 25.2% offered nicotine replacement therapy (NRT), such as nicotine patches or gum, and 21.5% offered non-nicotine cessation medications. Among substance abuse treatment facilities, 47.4% offered tobacco cessation counseling, 26.2% offered NRT, and 20.3% offered non-nicotine cessation medications.

The report indicates that wide variations exist across state boundaries. The percentage of mental health treatment facilities with smoke-free-campus policies ranged from 19.9% in Idaho to 77.7% in Oklahoma. The percentage of substance abuse treatment facilities with such policies ranged from 10% in Idaho to 83% in New York. Across states, the percentage of mental health treatment facilities offering tobacco cessation counseling ranged from 20.5% in Idaho to 68.2% in Oklahoma. In substance abuse treatment facilities, the percentage ranged from 26.9% in Kentucky to 85% in New York.

“Helping people with behavioral-health conditions quit smoking is a win-win,” said Doug Tipperman, SAMHSA’s Tobacco Policy Liaison, in a statement. “Quitting smoking reduces the risk of smoking-related diseases and could also improve mental health and addiction recovery outcomes.”

The report also notes that several steps to address barriers to making tobacco dependence treatment part of behavioral-health treatment, including:

  • Removing administrative and financial barriers to delivery of cessation interventions
  • Integrating tobacco screening and treatment protocols into facilities’ workflows and electronic health record systems.
  • Providing outreach to behavioral-health providers who could emphasize that patients can benefit from evidence-based cessation treatments, though longer duration or more intensive cessation treatments might be needed.

More than 50 years since the landmark first Surgeon General’s Report linked cigarette smoking to lung cancer, smoking remains the leading cause of preventable death and disease in the United States, killing nearly 500,000 citizens every year. Smoking-related diseases cost citizens nearly $170 billion annually in direct health care expenses.


CDC. Half of mental health facilities and a third of substance abuse treatment facilities have smoke-free campuses [news release]: Atlanta, GA; May 10, 2018. CDC Accessed May 10, 2018.

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