National Center of Excellence for Tobacco-Free Recovery

Through the National Center of Excellence for Tobacco-Free Recovery, CAI is engaging behavioral health providers, state agencies, people who use commercial tobacco products, and other stakeholders in efforts to reduce the high rate of commercial tobacco use among people with mental and substance use conditions.

People with behavioral health conditions consume 40 percent of the cigarettes that are manufactured in this country and smoke at disproportionate rates. (See the CDC website for citation and related statistics.)

For decades, the need to treat tobacco use among these populations has gone largely unmet due to a variety of factors, including myths that smoking supports behavioral health treatment and that people do not want to quit. Social determinants of health—such as poverty, lack of access to health care, and racism—and predatory marketing practices by the tobacco industry have also contributed to tobacco-related health disparities and a lack of effective treatment options.

The initiative

CAI is challenging these myths and addressing these environmental conditions through the National Center of Excellence for Tobacco-Free Recovery (CoE-TFR). This five-year initiative is engaging state-level stakeholders; behavioral health leaders and providers; and people who use commercial tobacco and their family members in changing policies, practices, and social norms related to commercial tobacco use among people with mental health and behavioral health conditions.

CAI’s National Center of Excellence for Tobacco-Free Recovery activities include:

  • Engaging a diverse set of experts who will serve as a national planning committee that informs all CoE-TFR activities.
  • Providing training to staff working in behavioral health care settings on effective evidence-based tobacco cessation interventions.
  • Providing technical assistance to foster implementation of evidence-based interventions; policy, systems, and practice changes; and connections to peers and resources.
  • Creating and maintaining an online hub for accessing quality resources and materials.
  • Convening Cross-State Leadership Academies for Tobacco-Free Recovery to build organizations’ capacity to plan and lead policy, system, practice, and social norm changes.

The impact

Through this initiative, CAI will engage at least 12 states, to make policy, systems, and practice changes that result in reducing current rates of commercial tobacco use among individuals with mental health and substance use conditions.


Substance Abuse and Mental Health Services Administration (SAMHSA).


To request technical assistance or if you are interested in convening a leadership academy, contact David Davis, Project Director: or 929-581-0861.


The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by SAMHSA, HHS, or the U.S. Government.