California’s Behavioral Health Transformation Must Include Co-treatment of Tobacco Use Disorder

Summary

Published Date: December 11, 2025

This is a critical time to address deficiencies in tobacco treatment and behavioral health. The Diagnostic and Statistical Manual of Mental Illnesses (DSM-5) classifies tobacco use disorder as a SUD under the same diagnostic umbrella as alcohol, opioid, and other drug use disorders. Partly for that reason, Assembly Bill (AB) 541, which took effect in 2022, requires SUD facilities to assess new clients for the condition and recommend tobacco cessation in their treatment plans, including referral to a cessation provider such as Kick It California, the state’s free tobacco quitline. However, there is no formal data collection process to ensure that these requirements are met. Moreover, AB 541 does not apply to mental health facilities. There is also confusion about coverage, as tobacco may not be mentioned in behavioral health service codes, 10 and medication costs are not covered by treatment programs but billed by dispensing pharmacies. At the same time, there are opportunities for improvement as health plans start measuring all members ages 12 and up for tobacco use and receipt of cessation interventions.