Why Focus on the Behavioral Health Sector?
In the U.S., approximately one in four adults have some form of mental illness or substance use disorder yet they consume nearly 40% of all cigarettes smoked by adults. Twice as many Kansas adults with a serious psychological distress status are current smokers (38.9%) compared to those without serious psychological distress (16.5%). Nicotine has mood-altering effects that put people with mental illness at higher risk for cigarette use and nicotine addiction. Yet, in Kansas, adults with serious psychological distress want to quit just as much as adults without serious psychological distress (58.2% vs. 56.6%). Research has shown that those with behavioral health conditions who are current smokers are four times more likely to have a premature death than non-smokers. This is a preventable health disparity in our state and country.
Overall, Kansas substance abuse and mental health treatment facilities need to improve tobacco use screening and treatment (see figures below). Figure 1 shows that Kansas falls behind the United States in tobacco cessation interventions across substance abuse treatment facilities: screening for tobacco use (50.0% vs. 72.4%); providing smoking/tobacco cessation counseling (44.2% vs. 57.3%); offering non-nicotine cessation medications (18.6% vs. 26.0%); and smoke-free campuses (20.9% vs. 33.5%). Figure 2 shows a similar picture for mental health treatment facilities with Kansas falling behind the United States: screening for tobacco use (44.6% vs. 57.1%); providing smoking/tobacco cessation counseling (37.6% vs. 43.6%); offering nicotine replacement therapy (22.8% vs. 27.5%); and smoke-free campuses (43.6% vs. 50.3%).
Figure 1. Tobacco Cessation Interventions and Smoke-Free Polices in Substances Abuse Treatment Facilities, Kansas vs. United States, 2020
There is already exciting state momentum in this area. KDHE Tobacco Use Prevention Program (TUPP) and partners have been participating in the Behavioral Health Tobacco Working Group, which is engaged in provider training, client education, and public awareness campaigns. The Working Group also participated in expanding Kansas Medicaid cessation benefits. Because of these efforts, Medicaid recipients in Kansas are now eligible for up to four rounds of any FDA-approved cessation medication per year with no lifetime caps, as well as ongoing cessation counseling services with no annual or lifetime caps.
Figure 2. Tobacco Cessation Interventions and Smoke-Free Policies in Mental Health Treatment Facilities, Kansas vs. United States, 2020
Together we can continue making statewide progress in raising awareness of this disparity and providing support to our community behavioral health facilities to elevate tobacco screening and treatment to the same level as any other substance.