People With Behavioral Health Conditions Encounter Barriers to Quitting Successfully

At a glance

  • Most people who smoke want to quit, and more than half of them try to do so each year.
  • Connecting every person who wants to quit with treatment proven to help them quit for good is important for improving people's health.
  • Descriptions of strategies that states and communities can use to help people quit smoking are below.
Young woman meditating at her desk

Barriers to quitting successfully

Most people who smoke want to quit, and more than half of them try to do so each year. Adults with mental health conditions who smoke want to quit, are able to quit, and have a better chance of quitting successfully when they have access to treatment.1

Proven treatments, such as FDA-approved medicines and behavioral counseling, make it more likely people will quit smoking successfully. People with behavioral health conditions can have challenges when trying to find and use these treatments:

  • In 2016, about half of mental health facilities (49%) and two-thirds of substance use treatment facilities (64%) screened patients for commercial tobacco use.A2 However, fewer than half of mental health and substance use treatment facilities in the United States offered proven treatments to help people quit smoking.23
  • Psychiatrists and other mental health professionals are less likely to talk about quitting smoking with patients who have behavioral health conditions. This may be due to misperceptions about the patient's willingness or ability to quit.4

Connecting people to resources is critical for health equity

Connecting every person who wants to quit with treatment proven to help them quit for good is important for improving people's health.

Examples of strategies that states and communities can use:

Provide barrier-free, widely promoted coverage for all evidence-based cessation treatments by all types of health insurance

For example, as of 2018, only 15 state Medicaid programs fully covered tobacco cessation (quitting) services for all traditional Medicaid enrollees.5

Integrate clinical screening and treatment for commercial tobacco use in all health care settings and with all types of patients

Talking to people about commercial tobacco use and quitting—as a regular part of health care visits in all care settings—will help make sure that all groups can get effective treatment to help them quit.6

Increase access to culturally tailored cessation services

When it comes to health issues, one size does not fit all. Different people and communities have varying needs and make decisions in different ways. People with behavioral health conditions may need more intensive treatment, or need treatment for a longer time, to quit smoking.7

Make all behavioral health care settings tobacco free, with no exceptions

Tobacco-free campus policies that prohibit use of all commercial tobacco products can support people who want to quit, make tobacco-free places the norm, and stop exposure to secondhand smoke.6 On campuses that are not entirely tobacco free, management can put rules in place to prevent staff from smoking with residents or providing cigarettes as an incentive or reward.86

Share health messages that feature people with behavioral health conditions and their experiences

Mass media campaigns are proven to increase smoking cessation, prevent people from starting to smoke, and reduce the prevalence of tobacco use.910 Anti-commercial tobacco messaging and mass media campaigns, like CDC's Tips From Former Smokers® (Tips®), are effective in reaching many groups. Tips ads feature testimonials from people with behavioral health conditions. Positive reactions to Tips ads have been shown to lead to more quit attempts.11

Fact sheets and guides

Websites

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Content Source:
National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health
  1. "Commercial tobacco" means harmful products that are made and sold by tobacco companies. It does not include "traditional tobacco" used by Indigenous groups for religious or ceremonial purposes.
  1. CDC Vital Signs. Vital Signs: Adult Smoking Focusing on People with Mental Illness [PDF - 3.2 MB]. Vital Signs. February 2013. https://www.cdc.gov/vitalsigns/pdf/2013-02-vitalsigns.pdf. Accessed Feb 25, 2022.
  2. Marynak K, Vanfrank B, Tetlow S, Mahoney M, Phillips E, Jamal A, et al. Tobacco Cessation Interventions and Smoke-Free Policies in Mental Health and Substance Abuse Treatment Facilities—United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(18):519-23. DOI: http://dx.doi.org/10.15585/mmwr.mm6718a3.
  3. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Tobacco Cessation Services. The N-SSATS Report. September 19, 2013. https://www.samhsa.gov/data/report/tobacco-cessation-services. Accessed Feb 25, 2022.
  4. Brown, CH, Medoff D, Dickerson FB, Fang LJ, Lucksted A, Goldberg RW, et al. Factors Influencing Implementation of Smoking Cessation Treatment Within Community Mental Health Centers. J Dual Diagn. 2015;11(2): 145-50. DOI: 10.1080/15504263.2015.1025025.
  5. DiGiulio A, Jump Z, Babb S, Schecter A, Williams KS, Yembra D, et al. State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments — United States, 2008–2018. MMWR Morb Mortal Wkly Rep. 2020;69:155–160. DOI: http://dx.doi.org/10.15585/mmwr.mm6906a2.
  6. Smoking Cessation Leadership Center. Fact Sheet: The Tobacco Epidemic Among People With Behavioral Health Disorders. Smoking Cessation Leadership Center, University of California; 2015. Accessed Feb 25, 2022. https://smokingcessationleadership.ucsf.edu/sites/smokingcessationleadership.ucsf.edu/files/Documents/FactSheets/The%20Tobacco%20Epidemic%2004_2022_R2.1.pdf.
  7. Lawn S, Pols R. Smoking Bans in Psychiatric Inpatient Settings? A Review of the Research. Aust. N. Z. J. Psychiatry. 2005;39:866–85. DOI: 10.1080/j.1440-1614.2005.01697.x.
  8. Lohr JB, Flynn K. Smoking and Schizophrenia. Psychiatr Danub. 2009;(3):371-5. https://pubmed.ncbi.nlm.nih.gov/19794359. Accessed Feb 25, 2022.
  9. U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. 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. Accessed April 28, 2022. https://www.ncbi.nlm.nih.gov/books/NBK179276/
  10. U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. [PDF - 10 MB]. 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; 2020. Accessed Feb 25, 2022. https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf.
  11. Davis KC, Duke J, Shafer P, Patel D, Rodes R, & Beistle D Perceived Effectiveness of Antismoking Ads and Association With Quit Attempts Among Smokers: Evidence from the Tips from Former Smokers Campaign. Health Commun. 2017; 32(8), 931-938. DOI: 10.1080/10410236.2016.1196413.