finding that black and Hispanic smokers are less
likely than white smokers to use smoking
cessation interventions such as nicotine
replacement therapy (NRT) and other
pharmaceutical therapies.^29
Special Populations. The need for addiction
treatment is disproportionately higher for
individuals with co-occurring mental health
disorders, for individuals involved in the justice
system and for members of the military,
including veterans, returning from active combat
in Iraq and Afghanistan:
In 2010, one in five (20.7 percent) non-
institutionalized individuals ages 18 and
older* with a diagnosed mental health
disorder† were in need of addiction
treatment (relative to 6.3 percent of those
without a diagnosed mental health disorder);
14.2 percent of those in need of addiction
treatment received it, leaving a treatment
gap of 8.5 million adults with co-occurring
addiction and mental health disorders.‡ 30 In
2010, only 37.6 percent of facilities
nationwide that provided addiction treatment
services offered services specific to patients
with co-occurring addiction and mental
health disorders.^31
In 2010, adults with a mental illness were
more than 1.5 times as likely as those
without a mental illness to have smoked
cigarettes in the past year (41.3 percent vs.
- Comparable data on those with mental health
disorders are not available for those ages 12-17.
† And/or a reported major depressive episode.
‡ Research indicates that young people with co-
occurring conditions are more easily identified as
needing treatment than those with addiction only.
One study found that unmet treatment need (i.e., the
treatment gap) was greatest for teens with addiction
(37 percent) compared to a relatively lower treatment
gap of 23 percent among those with a psychiatric
disorder only and 19 percent among those with co-
occurring disorders. Other research confirms that
rates of addiction treatment are approximately three
times higher for adolescent illicit drug users who
report having received mental health treatment in the
past 12 months compared to those who have not
received mental health treatment.
25.1 percent).^32 Even though patients with
mental health disorders are likelier to
smoke^33 and about as likely to want to quit
smoking as smokers in the general
population,^34 research suggests that smoking
cessation services for these patients are
rare.§ 35 In 2010, nearly half (46.8 percent) of
individuals who were arrested or booked in
the past year, but not incarcerated at the time
of the survey, were in need of addiction
treatment (relative to 8.0 percent of those
who had not been arrested or booked in the
past year); 27.9 percent of those in need of
treatment received it, leaving a treatment
gap of 2.5 million individuals.** 36 In 2010,
only 26.8 percent of facilities nationwide
that provided addiction treatment services††
offered services specific to patients involved
in the criminal justice system.^37 Among
inmates, only 11.2 percent receive
treatment.^38 Individuals involved in the justice system
also are likelier than the general population
to smoke^39 but are less likely to receive
tobacco cessation services.^40 One survey of
500 correctional facilities‡‡--including jails,
prisons and juvenile facilities--found that 80
percent reported that their facilities had no
tobacco cessation programs at all.^41 In 2005, of veterans from the military
operations in Iraq and Afghanistan who
sought health care from the Department of
Veterans Affairs (VA), 40 percent screened
positive for risky alcohol use and 22 percent§ Based on research documenting health care
practice; national data on the use of smoking
cessation treatments in this population are not
available.
** Comparable treatment admission data from the
Treatment Episode Data Set (TEDS), described on
page 141 and in Appendix A, are not available for
this population.
†† Excluding facilities such as jails, prisons or other
organizations that treat incarcerated individuals
exclusively.
‡‡ Accredited by the National Commission
on Correctional Health Care.