New Pathways, New Connections:

Tobacco and Behavioral Health

Frances M. Harding, DirectorSAMHSA’s Center for Substance Abuse Prevention

National Conference on Tobacco and Behavioral HealthBethesda, 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 MedicineSubstance 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