From the the first Annual National Conference on Tobacco and Behavioral Health, which occurred May 19-20, 2014 in Bethesda, MD and was hosted by the Central East Addiction Technology Transfer Center, a program of The Danya Institute. You can see videos from the conference on our website www.ceattc.org (go to “Tobacco and Behavioral Health Resources” under “Special Topics”). Opening plenary speech at the first Annual National Conference on Tobacco and Behavioral Health, which occurred May 19-20, 2014 in Bethesda, MD.

1. New Pathways,
New Connections:
Tobacco and
Behavioral Health
Frances M. Harding, Director
SAMHSA’s Center for Substance Abuse Prevention
National Conference on Tobacco
and Behavioral Health
Bethesda, Maryland
May 19, 2014

2. 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.

3. 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.

4. 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.

5. 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.

6. National Weighted Average
Retailer Violation Rate
National Weighted Average Retailer
Violation Rate Since 1997

7. • 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

8. 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

9. Emerging Issues
Softening of public attitudes
Changes in state and local laws

10. The Challenge of Integration
Single
state
agencies
and Synar
State
departments of
health and
broader
tobacco control
efforts

11. Collaborative Opportunities
Public Health Clinical Medicine
Substance Abuse Mental Health
Prevention Treatment

12. Tobacco Control Resources
www.TheRealCost.gov
FDA Public Education Campaign

13. Collaboration: Foundation for Success
Center for Substance Abuse
Prevention
Center for Mental Health Services
Center for Substance Abuse
Treatment
Center for Behavioral Health
Statistics and Quality
www.samhsa.gov