Background: Pennsylvanians with behavioral health conditions have higher rates of tobacco use. Meanwhile, research has documented the positive impact of addressing tobacco use concurrently with other substance use treatment. Provider misinformation about potential client resistance to tobacco-free recovery continues to be a barrier to its integration into behavioral health care.

Methods: In May 2023, The Pennsylvania Statewide Tobacco-Free Recovery Initiative conducted a statewide survey to assess interest in tobacco-free recovery among those who have used tobacco and received behavioral health treatment. The panel survey was distributed online via the Alchemer platform. Respondents were eligible if they were over 18, a Pennsylvania resident, had a history of tobacco use, and had received behavioral health treatment.

Results: Among the 750 participants, 61 of Pennsylvania’s 67 counties were represented. Most participants reported being treated for anxiety (n = 652) or depression (n = 577), with 80.4 percent receiving treatment for two or more behavioral health conditions. Almost 80% reported having used tobacco in the previous 30 days. The majority reported a desire to end their tobacco use (88.3%). Among those that stopped using tobacco in a facility, 75.2% indicate it was difficult, and most respondents indicate “withdrawal symptoms” as one of the difficulties. Over 85% of respondents were screened for tobacco use but over 50% were never offered behavioral counseling and over 40% were never offered nicotine replacement therapy (NRT).

Conclusion: Results from the panel survey demonstrate a need for and interest in tobacco-free recovery among respondents, despite diagnosis, treatment experience and/or geographic location. Respondents reported not receiving tobacco treatment/cessation services, like NRT and behavioral counseling, to support their tobacco recovery. Data from the panel survey is being used to demonstrate interest in tobacco-free recovery to improve access to concurrent tobacco recovery supports, reduce tobacco use disparities and improve behavioral health treatment outcomes.