Effective January 1, 2019, smoking and all forms of tobacco use will be prohibited at all residential drug and alcohol treatment programs under contract with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services’ (DBHIDS) Community Behavioral Health (CBH) division.
This policy is being enforced as a contract mandate for each of the 80 inpatient addiction treatment programs in the CBH provider network spanning four levels of care including nine detox facilities, 32 short-term rehabilitation programs, 31 long-term rehabilitation programs and eight substance use halfway houses.
Individuals who smoke cigarettes or use electronic nicotine delivery systems and are admitted to any of these facilities for substance use treatment will be offered medication and counseling to manage nicotine withdrawal while concurrently undergoing treatment for their admitting diagnosis. The policy applies to staff and visitors who will also be prohibited from smoking or bringing tobacco products and paraphernalia onto the premises.
Smoking is often part of a drug use ritual and is the leading cause of death and disability among behavioral health populations disproportionately. It is estimated that smoking-related conditions comprise 39 percent of deaths among opioid users, 40 percent among cocaine users and 49 percent among alcohol users.
Additionally, tobacco use kills more people than both opioid overdoses and gun violence in Philadelphia where surveys show smoking use among those with a substance use or alcohol problem to be at around 69 percent and 48 percent respectively. Smoking use among Philadelphians who report not using drugs or alcohol hovers at around 22 percent according to surveys.
Research also shows that people who have an addiction to drugs or alcohol are generally more likely to die from a smoking-related illness than from the other drugs they are ingesting. High smoking rates, frequent smoking and earlier smoking initiation render those with substance use disorder particularly vulnerable to tobacco-related harm.
“People who have a substance use disorder are smoking as much as three times the rate of the general population and, tragically, they are dying 25 years earlier than the general population largely because of smoking-related diseases affecting the lung and heart,” said Philadelphia’s behavioral health commissioner, David T. Jones. “Providing substance use treatment in a smoke-free environment will not only help us to improve addiction recovery outcomes for people, it will also help us to improve theiroverall health outcomes – consistent with our population health approach to delivering behavioral health services in Philadelphia.”
Quitting smoking while in recovery from drug addiction can increase long-term substance use abstinence rates by 25 percent. Studies show quitting during the recovery process also increases the likelihood of achieving and sustaining long-term recovery. By comparison, continuing to smoke after addiction treatment increases the likelihood of experiencing substance use relapse.
Data strongly supports the argument that many of those living with substance use disorder want to quit smoking and are more successful in doing so with evidence-based treatment provided by a clinician.
Tuesday’s policy rollout comes three years after the same contract mandate was successfully implemented at all acute inpatient psychiatric hospitals under contract with CBH. In both instances, treatment facilities provided input throughout the implementation process and the Philadelphia Department of Public Health and the University of Pennsylvania contributed as partners in the effort.