Table 1 Current regulations in states requiring tobacco cessation provision (n = 13/50, 26 %)

Alabama

The state psychiatric hospitals are tobacco free (effective 1/4/10) and smoking cessation therapies are provided. The Alabama Department Public Health offers smoking cessation education and whatever supports are necessary including medically supervised nicotine replacement, medications, support groups, and access to the Alabama quit-line. Additionally, the department certifies and contracts out with community providers who provide substance abuse services and requires that such entities shall directly or by referral provide a continuum of services for all clients/patients enrolled in each level of care that addresses tobacco use.

COMBINED

Arkansas

In Arkansas the Department of Behavioral Health Services (DBHS) policy that all licensed substance abuse programs must be smoke-free under the 2009 Clean Indoor Act. In 2013, DBHS made a requirement that all contracted substance abuse centers provide tobacco cessation as a part of routine treatment in October 2013 and become tobacco-free on June 1, 2014.

SA

Louisiana

In 2012, the Louisiana legislature passed house bill 80, now referred to Act 373, to prohibit smoking in psychiatric facilities of the Department of Health and Hospitals and to establish procedures for treatment of smokers with mental illness in such facilities.

MH

Maryland

Requires as a condition of grant award that all patients are screened for nicotine dependence disorders and if identified must be included and addressed in the patient’s treatment plan. This requirement is for all American Society of Addiction Medicine (ASAM) levels of care.

COMBINED

Massachusetts

Licensing requirements for the state’s substance abuse facilities include providing counseling and education. However, FDA-approved medications for tobacco cessation, an evidence-based standard of care since at least 2008, are not provided by the majority of substance abuse facilities. Also, if facilities receive special grant money in a given year, they sometimes provide nicotine patches to clients, but that is on a special basis and not part of standard licensing.

SA

New Hampshire

All treatment contracts include the following statement: “the Contractor shall have policies and procedures for both client and Contractor staff, that not only creates a tobacco-free environment as required by law, but to offer tobacco cessation tools and programming.”

COMBINED

New Jersey

“The contractee shall provide all services under this contract in a smoke-free environment. All treatment planning shall include education on tobacco use. The contractee shall work toward development of a tobacco-free program.”

UNKNOWN

New York

As of 2008, all facilities treating drug or alcohol addiction must have programs in place to encourage clients to stop smoking. All treatment centers are required to be smoke-free, and staff members must abide by the ban.

SA

North Carolina

The state’s psychiatric hospitals, treatment facilities and residential developmental centers are regulated by entities that require active treatment for nicotine addiction/tobacco treatment. All identified active problems require active treatment and the state is striving to refine and improve the way it provides active treatment in various domains.

MH

Oklahoma

Statewide policy requires that the Oklahoma Department of Mental Health and Substance Abuse Services offer tobacco cessation for their clients.

COMBINED

Oregon

Oregon has enacted regulations and policies that require tobacco cessation therapy services in state residential substance abuse treatment facilities and psychiatric hospitals. State administrative rules from the Oregon Health Authority's Addictions and Mental Health (AMH) Division require that both residential and outpatient facilities provide tobacco cessation services along with other substance abuse treatment and recovery services.

COMBINED

Texas

Department of State Health Services (DSHS), who operates state psychiatric hospitals, has had a tobacco-free campus policy since 2004. Since 2010, providers who are contracted with DSHS to provide substance abuse treatment services have been required to provide treatment for tobacco dependency to clients who are being admitted for substance abuse treatment.

SA

Vermont

The Vermont Department of Health Division of Alcohol and Drug Abuse Programs provides grants to substance abuse treatment centers throughout Vermont, which are referred to as “preferred providers.” In July 1, 2013, those grants included a provision requiring all preferred providers to adopt tobacco-free campus policies, including integrating tobacco addiction into treatment plans. Vermont does not have a state policy for mental health facilities.

SA