Medication to Stop Smoking: Responding to the Attack on Smoking Cessation by the Federal Government

If any reader can enlighten me as to the rationale for the dismantling of longstanding Federal efforts to reduce tobacco use and ensure access to evidence‑based treatment, including medication to stop smoking, I would very much appreciate hearing from you. This month I had the opportunity to witness the impact of this decision when I represented the American Society of Addiction Medicine at the 2025 meeting of the National Partnership on Behavioral Health and Tobacco Use.

The National Partnership on Behavioral Health and Tobacco Use was established in 2016 by the Smoking Cessation Leadership Center (SCLC) at the University of California San Francisco and the American Cancer Society to address the continued high use of tobacco by people with mental health and substance use disorders — groups that disproportionately bear the burden of smoking‑related illness and death. Adults with behavioral health conditions represent about 25 % of the U.S. population but consume up to 40 % of cigarettes smoked nationwide, making this disparity a major public health and equity issue. UCSF Smoking Cessation Leadership Center

Among the many organizations represented at the meeting were the American Lung Association, the National Alliance on Mental Illness, the American Academy of Family Physicians, the American Psychiatric Association, and the National Association of Social Workers. The only Federal agency present was the Department of Veterans Affairs — with notable absences from the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA), reflecting a withdrawal of visible Federal engagement in coordinated tobacco treatment and prevention. 

Many attending organizations reported a crippling of their tobacco‑related efforts because of the pullback of Federal financial support — funding that previously helped expand access to cessation resources, training and technical assistance, and public health programming. SCLC’s past designation as SAMHSA’s National Center of Excellence for Tobacco‑Free Recovery made possible a range of educational tools, technical assistance, and collaborations to help behavioral health providers implement treatment protocols tailored to people with serious mental illness and co‑occurring disorders. 

To make matters worse, the primary funder for the Partnership — the Robert Wood Johnson Foundation — is pivoting away from its longstanding focus on tobacco and will no longer be providing support, thus imperiling the future existence of the Partnership and threatening momentum built over nearly a decade.

Despite these bleak developments, the attendees were spirited and feisty — one member even described our efforts as “patriotic.” I learned that the people at the meeting, whose professional careers centered on the problems created by nicotine and tobacco use, are very accustomed to encountering challenges and are not deterred by them. No matter the future of the Partnership, nor the absence of Federal government support in dealing with tobacco and nicotine addiction, the people at the meeting will find ways to continue their work expanding access to affordable, evidence‑based cessation services, including medication to stop smoking. I look forward to collaborating with them.

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