430,000 Americans are dying every year from tobacco caused and related diseases.  It is estimated by leading tobacco authorities that 200,000 of these deaths are those with alcohol, drug or mental health disorders.  There are 5 million tobacco deaths world-wide.  This death toll is expected to more than double in the next century as tobacco companies focus more on developing countries where strong tobacco prevention and control does not exist.

In Wisconsin there are 8,000 tobacco deaths annually.  Our residents with substance dependence and mental health disorders account for 3,520 of these deaths. That is 290 deaths a month in our state; or 10 a day. This is not a one year death toll.  Half of our family members, friends and co-workers who are addicted to nicotine and have substance abuse and mental health disorders will die from lung cancer, emphysema, heart disease and other cancers and lung disease.  Sadly, those who die from tobacco this year are being replaced by new smokers; our children.

Meanwhile, Wisconsin has a state-wide network of alcohol and drug treatment programs and county counselors who are trained to produce abstinence-based treatment and recovery plans for patients with substance dependence disorders.

We also have state-wide mental health services active in every county of the state.  Although we now have evidence-based nicotine treatment practices that are effective these services are not available to patients with substance dependence and mental health disorders. 

Now that we have nicotine treatment that works and we have substance abuse and mental health treatment providers it is time to train those working in these fields with the skills and knowledge they need.  Addiction treatment programs can treat nicotine dependence in their existing facilities and programs.  Mental health professionals can be trained to either offer nicotine dependence or have access to other resources were their patients can get the treatment they need.

After 5 years of advocacy and preparation Wisconsin is now in a position to energize the planning process and develop implementation strategies that effectively address the high prevalence of nicotine dependence in these special needs populations.