Dr. Tim McAfee, MD,MPHDirector, CDC Office on Smoking and Health

Tobacco Control and Behavioral Health: National Networks and CDC’s Role

National Center for Chronic Disease Prevention and Health Promotion

Office on Smoking and Health

National Conference on Tobacco and Behavioral Health: Interventions, Integration, and Insurance

May 19, 2014

CDC Office on Smoking and Health

VISION A world free from tobacco-related death and disease

GOALS � Prevent initiation of tobacco use among youth and

young adults� Promote tobacco use cessation among adults and

youth� Eliminate exposure to secondhand smoke� Identify and eliminate tobacco-related disparities

IDENTIFY

Success with the LGBT Community

� Smoking behavior for this population not routinely available

� Pride advocacy group of Puerto Rico worked with the National Latino Tobacco Network and the Network for LGBT Tobacco Control

� Data collected at the 2009 PRIDE fest used to demonstrate to decision makers the value of adding questions to the national tobacco survey

The Burden

Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years with Mental Illness—United States, 2009–2011 February 8, 2013 / Vol. 62 /

AMI

Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years with Mental Illness—United States, 2009–2011 February 8, 2013 / Vol. 62 /

AMI Variation Across Groups

� Prevalence lowest among Asians with AMI and highest for Whites

� However: difference in prevalence between Asians with AMI and without was highest of any group� 2X higher overall� 3X higher for women

Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years with Mental Illness—United States, 2009–2011

February 8, 2013 / Vol. 62 /

Greater Risk

� Mood-altering effects of nicotine� Issues that make it challenging to quit� Lack of knowledge of the health effects� Tobacco industry targeting

Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Yearswith Mental Illness—United States, 2009–2011 February 8, 2013 / Vol. 62

/

ELIMINATE

Evidence-Based Interventions

� Sustained funding of comprehensive programs

� Price increases� 100% smoke-free policies� Hard-hitting media

campaigns� Cessation access

SGR 2014

“ The evidence is sufficient to conclude that tobacc o cessation treatments are effective across a wide population of smokers, including those with signifi cant mental and physical comorbidity”

Chapter 14: Conclusion 8

Cessation is Possible

“Research indicates that smoking cessation interventions with individuals experiencing mental or substance use disorders are feasible, beneficial, and needed.”

“Smokers with mental illness can quit and remain abstinent from cigarettes during mental health treatment, and that this is a promising setting to promote smoking cessation.”

The health consequences of smoking – 50 years of progress: a report of the Surgeon General. –Atlanta, GA. : U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

Chapter 12- Appendix 14.4. Pages 10-11.

Challenges

Tailored

DisseminationIntegration

Carve outSpecial services

Challenges

Mental Health/Substance Abuse

Bipolar

Schizophrenia

Low SESAI/AN

CDC Initiatives

� Healthy People 2020 objectives � HHS Strategic Plan� Best Practices

CDC Initiatives

� Research � State Tobacco Program Activities� Collaborations

National Networks

� To support a stronger infrastructure to understand and reach populations experiencing disparities

� 8 specific networks � National African American Tobacco Prevention� Inter-Tribal Council of Michigan� Asian Pacific Partners for Empowerment, Advocacy, &

Leadership� National Alliance for Hispanic Health� Centerlink� National Council for Behavioral Health� Community Anti-Drug Coalitions of America� (Low Socioeconomic)

� To prevent and reduce tobacco use and cancer among those with mental illness and substance abuse disorders

Tips from Former Smokers

Earned Media

For more information please contact Centers for Dis ease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Other Successes

� African American Network’s work on Menthol and Smoke-free policies

� Break Free Alliance partnership with NAQC to review Quit Line use for Low SES and Blacks

� APPEAL assisted MN to develop a comprehensive plan for addressing diverse communities

� LGBT Network spearheaded initiative to expand data collection across HHS

� AI/AN network trained tribes and implemented the AI ATS