Tobacco/Nicotine Integration Report from States

Efforts to integrate the treatment of tobacco dependence into the care of those with mental illness and/or other substance abuse disorders are growing across the country. For example, a recent webinar about what is known about helping people with schizophrenia quit tobacco attracted more than 300 people. A number of states have launched integration efforts that reflect their priorities and funding levels. Some have tackled integration into the AODA health system while others have taken on the mental health system. Few have done both at once as we are doing in Wisconsin. It’s an old story about funding tobacco control efforts as well as mental health/AODA programs: promising initiatives are dismantled due to budget cuts. (Suffering through the vagaries of funding cut backs is another common bond between tobacco control and AODA/mental health care, albeit an unfortunate one.) Very prominent, leading integration efforts in New York and New Jersey have been stalled due to budget cuts.

New Jersey: New Jersey is the nation’s pioneer state when it comes to integrating evidence-based nicotine treatment into addiction and mental health programs.  Sadly, due to extreme budget cuts; loss of talented, experienced tobacco treatment specialists and health department re-organization New Jersey is not able to sustain their excellent services. However, they do have some professional tobacco leaders continuing the nicotine integration struggle. For more on New Jersey go to: http://www.tobaccoprogram.org/index.htm

New York State: NYS is the nation’s leading tobacco integration state for alcohol and other drug treatment; perhaps the world’s leading integrator.  NYS has implemented a statewide tobacco/nicotine integration program that requires licensed addiction treatment providers to maintain a tobacco-free environment and integrate evidence-based nicotine dependence treatment into all levels of care.

After 2 years of this expansion of addiction treatment provider’s scope of practice that addresses tobacco and nicotine treatment, the state reports 90% compliance with this new regulation. For more on New York State go to: http://www.oasas.state.ny.us/regs/856.cfm
http://www.oasas.state.ny.us/tobacco/providers/training.cfm
http://www.tobaccorecovery.org/
http://www.health.state.ny.us/prevention/tobacco_control/
www.youtube.com/watch?v=M_JupkrKWQE

Massachusetts: Massachusetts has addressed tobacco and nicotine in its addiction programs for more than 16 years.  Janet Smeltz is the program coordinator and another of the nation’s tobacco/nicotine integrators. Tobacco and substance use disorders are in the same government department. For more information go to:
http://www.healthrecovery.org/projects/tobacco_education_and_treatment/tape.asp

Indiana: Indiana is another state making significant progress in its efforts to integrate tobacco/nicotine dependence treatment into its state addiction programs.  Indiana requires addiction programs funded by the state to make a good faith effort to integrate evidence-based nicotine treatment into its services and provide tobacco-free facilities. Go to:
http://www.in.gov/itpc/
http://alcoholism.about.com/od/tx_in/qt/agency_indiana.htm
http://www.mentalhealthassociation.com/rethinktobacco.htm

California: California has a long history of tobacco related policies that identify California as a state committed to reduce harm from tobacco. Currently the University of California at San Francisco has Steven Schroeder, M.D. leading a program designed to address tobacco and integrate nicotine dependence into California’s mental health and substance use disorders. For more California go to: http://smokingcessationleadership.ucsf.edu/Pioneers.htm
http://smokingcessationleadership.ucsf.edu/BehavioralHealth.htm
http://smokingcessationleadership.ucsf.edu/index.htm
http://www.cdph.ca.gov/programs/tobacco/Pages/default.aspx

Colorado: Colorado has a long-standing reputation as a leader in tobacco and mental health, education, training and research.  Their Bringing Every One Along (BEA) program and manuals have been a welcome addition to the tobacco/mental health/substance dependence. For more Colorado information go to: http://www.tcln.org/bea/resources.html
http://smokingcessationleadership.ucsf.edu/Downloads/Steppsudtoolkit.pdf

Virginia: Janis Dauer is another of the early pioneers striving to integrate tobacco/nicotine into Virginia behavioral health programs with a special interest in professional tobacco treatment specialist certification. For more information on Janis and Virginia go to: http://www.jigsaw.com/scid15467727/janis_dauer.xhtml

Oregon: Go to: http://www.oregon.gov/OHA/addiction/tobacco-freedom/main.shtml