People with Behavioral Health Disorders

Tobacco use is the number one preventable cause of death among those with behavioral health disorders. On average, people with co-occurring behavioral health disorders and tobacco-use disorder lose 25 years of their lives due to tobacco use. In addition to the adverse health effects from tobacco use, a number of studies show that smoking has been found to be predictive of future suicidal behavior among youth and adults independent of depressive symptoms, prior suicidal acts and other substance use. It is important to note that there is evidence that quitting smoking appears to mitigate the risk.

However, people with behavioral health disorders can and want to become tobacco-free. Becoming tobacco-free has significant positive effects on behavioral health:

  • For those with substance use disorders, becoming tobacco-free is associated with increased likelihood of long-term abstinence from other drugs; and
  • Becoming tobacco-free has been found to have as much positive effect on mood and anxiety symptoms as anti-depressant treatment.

QuitlineNC Behavioral Health Program QuitlineNC Behavioral Health Program These are reasons why QuitlineNC offers a specialized protocol to those who have a behavioral health condition and feel that it will affect their ability to become tobacco-free. For more information, check out this flyer about the behavioral health protocol (PDF, 800 KB). Here is a brochure for your clients about the Behavioral Health Program. Here is the brochure in Spanish.


The following resources can help you to integrate tobacco-use treatment into treatment for those with co-occurring behavioral health conditions:

SAMHSA resources:

Tobacco-free policies help people become and stay tobacco-free. Need help implementing a tobacco-free policy at your behavioral health program? Contact your local tobacco prevention and control regional manager.

Also, check out this infographic from, as well as the implementation guides from SAMHSA in the links above.


1. Prochaska JJ, Das S, Young-Wolff KC. Smoking, Mental Illness, and Public Health. Annu Rev Public Health. 2017;38:165–185. doi:10.1146/annurev-publhealth-031816-044618