New Pathways,

New Connections:

Tobacco and

Behavioral HealthFrances M. Harding, Director

SAMHSA’s Center for Substance Abuse Prevention

National Conference on Tobacco

and Behavioral Health

Bethesda, Maryland

May 19, 2014

Creating communities

where individuals, families, schools,

faith-based organizations, and

workplaces take action to:

• Promote emotional health

• Reduce the likelihood of mental illness,

substance abuse including tobacco, and

suicide

SAMHSA Strategic Initiative #1:

Prevention of Substance Abuse and Mental Illness

SAMHSA’s objectives include: Reduce tobacco use

among youth and persons with mental and

substance use disorders.

Addressing Tobacco and Behavioral Health

• 480,000 tobacco-related U.S. deaths each year

• People with mental and substance use disorders:– Almost half of all U.S. tobacco deaths

– 40 percent of all cigarettes smoked by adults

• People with mental illness:– Tobacco dependence most prevalent drug abuse disorder

Smoking tobacco causes more deaths among clients in

substance abuse treatment than the alcohol or drug

use that brings them to treatment.

Collaborating to Address the

Behavioral Health Disparity in Tobacco Use

• SAMHSA is working with agencies

across the U.S. Department of

Health and Human Services

through the Working Group on

Tobacco Control in Behavioral

Health.

The Primary Goal: To promote the implementation of tobacco-

free policies and integration of tobacco cessation into

treatment in behavioral health settings.

Smoking in Youth: Behavioral Impact

• People who start smoking before the

age of 21 have the hardest time

quitting.

• About 30 percent of youth smokers will

continue smoking and die early from a

smoking-related disease.

• Teen smokers are more likely to use

alcohol and illegal drugs.

• They are more likely to have panic

attacks, anxiety, disorders, and

depression.

National Weighted Average

Retailer Violation Rate

National Weighted Average Retailer Violation Rate Since 1997

• Teen cigarette smoking down by half since 2002

• Synar program:

– Direct effects on youth smoking

– Two-thirds of states: sales rates < 10 percent

– Multiple strategies work best

– Link Synar effort with the larger tobacco

control arena

• Family Smoking Prevention and Tobacco Control Act

• HHS tobacco control strategic plan

• CDC’s National Tobacco Control Program

Meeting the Challenge of Youth Tobacco Use

The Changing Face of Tobacco Control

• Family Smoking Prevention and

Tobacco Control Act

– FDA authority to regulate tobacco

(The Center for Tobacco Products)

• SAMHSA and FDA meet monthly for

coordination meetings

• HHS-wide tobacco control strategic

plan

• SAMHSA: integrating tobacco

prevention and cessation in state

Substance Abuse Prevention and

Treatment Block Grant application

Emerging Issues

Softening of public attitudes

Changes in state and local laws

The Challenge of Integration

Single

state

agencies

and Synar

State

departments of

health and

broader

tobacco control

efforts

Collaborative Opportunities

Public Health Clinical Medicine

Substance Abuse Mental Health

Prevention Treatment

Tobacco Control Resources

www.TheRealCost.gov

FDA Public Education Campaign

Collaboration: Foundation for SuccessCenter for Substance Abuse

Prevention

Center for Mental Health Services

Center for Substance Abuse

Treatment

Center for Behavioral Health

Statistics and Quality

www.samhsa.gov