Despite advances in lowering the rate of tobacco use and its health consequences, certain groups
have not benefitted from this progress. Chief among them have been persons with mental illness
and/or substance use disorders, collectively known as the behavioral health population.1
The facts and resources cited below are sorted by:
Many of the resources and information can be used across these sometimes distinct and sometimes overlapping populations.
In addition, a table of prescription behavioral health medications that are impacted by nicotine is included at the end of the document.
Within this document the nomenclature used for the priority population reflects the original
Individuals with mental illness may also have substance use disorders. The combination of these two illnesses has its own term: co-occurring disorders or dual diagnosis. Either disorder (substance use or mental illness) can develop first. According to the National Survey of Drug Use and Health, 9.2 million US adults experienced both mental illness and a substance use
disorder in 2018.26
According to the Pennsylvania Department of Health website, the prescription opioid and heroin overdose epidemic is considered the worst public health crisis in Pennsylvania, affecting Pennsylvanians across the state, from big cities to rural communities.
Prescription drugs are known to interact with other drugs, certain foods, smoking, and smoking cessation. In most cases it is the tobacco smoke, not the nicotine, that causes the interactions. Tobacco smoke influences absorption, distribution, metabolism or elimination of other drugs, potentially causing an altered response. People who smoke may require higher doses of medications. Upon cessation, dose reductions might be needed.44