Q&A with the Commissioner

1. Why are you committed to addressing tobacco dependence in New York State’s chemical dependence services?

A. This is the single most preventable cause of death. New York’s prevention and treatment providers are making history this July 24, when we become the first state in the nation to have tobacco-free policies at all programs certified or funded by OASAS.
The health benefits to the 110,000 New Yorkers within the OASAS system on any given day are monumental. These are the facts: Tobacco-related disease kills more people than all other addictive drugs combined. Also, tobacco-related deaths also outpace all deaths from AIDS, homicides, firearms, and motor vehicle accidents combined.
The dangers of tobacco use for both those addicted and those affected by second-hand smoke are significant. Up to 92 percent of the chemically dependent population smokes, even though our state rate of smokers in the general population is 18.2 percent. Research has also shown that those in chemical dependence treatment who smoke are more likely to die from tobacco-related illness than from alcoholism or drugs.

2. You may have heard Dr. Jonathan Foulds of UMDNJ describe those who suffer from mental health and/or substance use disorders as the “forgotten smokers,” using tobacco at 2-3X the rate of the general population. Given this alarming statistic, why do you think that it has taken decades for the field to address this deadly addiction?

A: The field has struggled with this addiction issue. But there is science that shows us that tobacco negatively impacts recovery rates from other substances. Also, cravings for nicotine increase the cravings for other drugs. Studies also show that people who stop smoking along with their other addictive substances, have a greater likelihood of avoiding relapse.
We need to educate the culture and the addictions field on this issue. New York State enacted the Clean Indoor Air Act five years ago resulting in a decline in the number of New York smokers. Evidence-based strategies to change community norms and the community environment will result in a cultural shift.

3. The Clinical Practice Guidelines Update 2008 public health message is clear- it is the responsibility of all healthcare providers to address tobacco use and dependence with all patients at every point of contact. How is the NYS addiction professional prepared to respond to this call to action?

A. OASAS has traveled the state, discussing the regulation and offering guidance and assistance. We have reached approximately 4,000 individuals and an additional 2,700 people have utilized our on-line training focusing on tobacco. Our tobacco-free website receives approximately 20,000 visits each month.

OASAS has worked closely with the NYS DOH to ensure that training is available for the field to prepare counselors, medical staff, and administrative staff. The focus is on de-normalizing the use of tobacco and integrating tobacco-free into all treatment.The Professional Development Program was awarded the grant to provide statewide training. They are developing resources that will be available online and regional trainers will be available to assist programs.

4. What do you think the lessons learned from this groundbreaking initiative will be?

Our goal is to save lives afford individuals we serve a life in recovery that includes wellness. This regulation is the right thing to do. I believe we will wonder why we didn’t do this sooner.