Ending Tobacco Dependence for Individuals With Mental Illness and Substance Abuse Disorders
On average, individuals with mental illness die up to 25 years before their counterparts in the general population. Tobacco use is a huge contributing factor. “People tend to assume that people with serious mental illnesses are dying years earlier than the general population because of things like suicide or the side effects of homelessness. But that’s not the case. They’re dying because of chronic conditions like diabetes, heart attacks, strokes, chronic obstructive pulmonary disease, or cancer, all of which are a direct result of tobacco use,” says Kim Richter, director for the tobacco cessation program at the University of Kansas Medical Center. Specifically in Kansas, the reported smoking rate among adults with mental illness is more than twice the smoking rate among adults without mental illness. A 2015 research report concludes that “people with high levels of psychological distress continue to smoke at particularly high rates, and may benefit less from existing tobacco control measures.” The current available evidence, is summarized in What We Know: Tobacco Use and Quitting Among Individuals with Behavioral Health Conditions.
Behavioral Health Tobacco Project
NAMI Kansas is the lead organization for the Behavioral Health Tobacco Project, a collaborative undertaking funded by the Kansas Health Foundation and focused on expanding health insurance coverage and access to evidence based treatment for individuals with mental illness and substance use disorders. The broad goal is to significantly reduce the number of Kansans in this target population who use tobacco products. We are working closely with the organizations listed below to have the largest possible impact.
Aetna Better Health of Kansas ▪ American Cancer Society Cancer Action Network ▪ American Heart Association ▪ American Lung Association ▪ Association of Community Mental Health Centers of Kansas ▪ Community Care Network of Kansas ▪ CRO Network ▪ Johnson County Mental Health ▪ Health ICT ▪ Kansas Academy of Family Physicians ▪ Kansas Association of Addiction Professionals ▪ Kansas Association of Local Health Departments ▪ Kansas Department for Aging & Disability Services ▪ Kansas Department of Health and Environment▪ KIDS Network/Kansas Infant Death and SIDS Network ▪ KU Medical Center ▪ Lawrence-Douglas County Health Department ▪ March of Dimes ▪ Mental Health Association of South Central Kansas ▪ NAMI Kansas ▪ New Directions for Behavioral Health ▪ Prairie View ▪ Sunflower State Health Plan ▪ Tobacco Free Kansas Coalition ▪ United Health Care
The Guideline is designed as a road map for providers to support their clients who are motivated to end their dependence on tobacco products. The Guideline is based on 12 essential strategies and includes a list of resources to assist providers in adopting specific practices that integrate tobacco cessation with other behavioral health treatment. We invite health care providers and their associations to endorse the Guideline as an aspirational statement. Click here to see which provider agencies and associations have endorsed the Tobacco Guideline. Download the Endorsement Notification form for additional information about what endorsement means for both provider organizations and associations and to confirm an organization’s endorsement of the Guideline. [Please note, this is a fillable PDF form.]
This self-assessment tool is a companion document modeled on the 12 strategies in the Tobacco Guideline for Behavioral Health. Health care providers may use the tool to estimate the extent to which the strategies are being implemented and to describe how implementation is taking place. Completing the self-assessment will help providers identify the gaps in addressing the Tobacco Guideline. Download the Self-Assessment tool to get a fillable PDF form for use by your organization.
This is an 85 page companion document for health care providers (both behavioral health care and primary care providers) providing detailed guidance for implementing each of the 12 strategies outlined in the Tobacco Guideline for Behavioral Health. The online version of the Toolkit available here includes links to dozens of additional resources. The online version can be downloaded and printed. A limited number of print copies will also be available. Contact NAMI Kansas for more information.
Expanded Tobacco Cessation Benefits for KanCare Enrollees – This handy card describes the new counseling and pharmacy benefits beginning in 2018 to support KanCare members who are seeking to end their dependence on tobacco. Click here to order copies or to download a high resolution file to print copies for your use. Samples of 11×17 posters are also available to promote the new KanCare benefits. Share these two short videos to drive utilization of the expanded benefits: a peer-to-peer video featuring a patient who successfully used the KanCare benefits to quit tobacco and a provider video featuring a physician who is encouraging other providers to engage patients to utilize cessation benefits. Click on these links for more detailed guidance from KanCare about the expanded counseling benefits and the expanded pharmacy benefits. Finally, online training is available for primary care and behavioral health care providers to learn about how to get reimbursed for providing tobacco treatment under different types of insurance plans, including Kancare.
The Economics of Proactive Smoking Cessation Treatment for Individuals with Serious Mental Illness and/or Substance Use Disorder in the Medicaid Population – An economic study prepared for NAMI Kansas by Tami Gurley-Calvez, MA, PhD and Christiadi, MA, PhD, University of Kansas School of Medicine.
Resources for Ending Tobacco Dependence
Building Capacity for Tobacco Treatment in Kansas – Click this link to learn about opportunities to provide health care professionals in Kansas with access to tobacco treatment resources and professional development opportunities, including three training opportunities in 2018.
Kansas Tobacco Resources from the Public Health Law Center – These Kansas specific resources provide guidelines on drafting smoke-free school policies and information about adopting smoke-free policies within multi-unit public housing.
National Behavioral Health Network for Tobacco & Cancer Control – The National Behavioral Health Network for Tobacco & Cancer Control (NBHN) is 1 of 8 Centers for Disease Control and Prevention (CDC) national networks that ignite action to eliminate tobacco- and cancer-related disparities. NBHN serves as a resource hub for health care professionals seeking to combat disparities specifically impacting people with mental illnesses and addictions. See their Resources and Sample Policies for transitioning to a tobacco-free facility and their infographic on how to implement a tobacco-free policy. Watch this 5 minute video – Putting Practice into Action with a Tobacco-Free Policy.
Adopting and Implementing An Effective Smoke-Free Housing Policy – The website supports implementation of smoke-free housing policies by sharing practical ideas ad insights from housing providers and residents who have already gone smoke-free.
Resources for Tobacco-Free Worksites from WorkWellKS
Presentation Slides: Implementing Tobacco Treatment & Recovery in Behavioral Health
Tobacco Cessation Treatment: What Is Covered? A useful overview from the American Lung Association addresses coverage specifics for different types of health insurance. See specific details for Kansas insurance plans. Access free online training- Navigating the Reimbursement Maze – regarding coding, billing and reimbursement for tobacco treatment.
Tobacco Cessation Coverage for Veterans. The linked document from the American Lung Association provides details on tobacco cessation benefits from the Veterans Health Administration. More information is available at https://www.mentalhealth.va.gov/quit-tobacco/ or by calling 1-855-QUITVET (1-855-784-8838).
What about the uninsured?
For uninsured individuals, free coaching is available for tobacco and e-cigarette users from the Kansas Tobacco Quitline (1-800-QUIT-NOW, https://kansas.quitlogix.org/en-US/), including limited quantities of NRT for those who qualify under the Quitline’s Behavioral Health Program. Free medications can also be accessed for those who qualify under Pfizer’s prescription assistance program https://www.pfizerrxpathways.com/.
U.S. Preventive Services Task Force Recommendations for Tobacco Cessation Treatment – Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions – Tobacco Use in Children and Adolescents: Primary Care Interventions
What helps a smoker quit? In these videos from CDC’s Tips From Former Smokers campaign, Rebecca reveals that the birth of her grandson motivated her to quit for good. She made other healthy changes too. She sought help for her depression and began to exercise. As a result, she is healthier and happier.
- Rebecca Videos: http://www.cdc.gov/tobacco/campaign/tips/resources/videos/rebecca-videos.html
- Podcast: http://www2c.cdc.gov/podcasts/player.asp?f=8639229
- Print Ad: http://www.cdc.gov/tobacco/campaign/tips/resources/ads/tips-5-rebecca-full.pdf
- Mental Health Care Professionals: Help Your Patients Quit Smoking: http://www.cdc.gov/tobacco/campaign/tips/partners/health/mental/index.html
- Web Button for Rebecca Campaign (under Mental Health Conditions: Depression and Anxiety):http://www.cdc.gov/tobacco/campaign/tips/resources/buttons/index.html
Smokefree.gov – Resources from the National Institutes of Health – smokefreevet, smokefreewomen, smokefreeteen, smokefreeespañol, smokefree60+
Tobacco and Behavioral Health: The Issue and Resources – Substance Abuse and Mental Health Services Administration
Resources for Youth
KDHE Tobacco Cessation Resources
The Kansas Department of Health and Environment Tobacco Use Prevention Program will provide materials free of charge to promote tobacco cessation resources available through KanCare (Kansas Medicaid). Resources are available that target both providers and KanCare participants. Click here to view and order available materials.
Download the Quitline flyer outlining service enhancements to individuals with mental illnesses and substance abuse conditions.