Background and challenges to implementation:
Prevalence of tobacco use and mortality from tobacco-related diseases are disproportionately higher among individuals with mental health and substance use disorders compared to the general population. In the U.S., people with serious mental illnesses die on average 25 years younger than other Americans, and much of this mortality is due to tobacco use. Some mental health care providers are reluctant to treat and some lack the training on how to effectively treat tobacco dependence, and how to use available resources to get smokers with mental illness and substance use disorders the longitudinal counselling, medications, and follow-up they need to be tobacco free.

Intervention or response:
We provided 1) an accredited Tobacco Treatment Specialist (TTS) Training that includes an 8-hour online training and a 3½ day in-person core training that covers brief intervention, intensive counselling, cessation medications, follow up, and clinic systems change 2) Post-training monthly conference calls to work with TTSs on challenging cases and share current information. Additionally, all TTSs received 18-months paid membership of the Association for the Treatment of Tobacco Use and Dependence (ATTUD).

Results and lessons learnt:
To date, thirty-nine participants with an average of 11 years of experience working in behavioral health programs are enrolled in the program. Less than half of the participants (16) held a supervisory role. Eleven of the participants were males and 28 were females. The median pretest treatment knowledge score was 60%; following training the median posttest score was 80%. Final comprehensive exams were taken within 6 weeks of the training and the average score was 86%. Over 98% of the participants were very satisfied with the course and 98% of participants indicated their ability to deliver effective tobacco treatment significantly increased.

Conclusions and key recommendations:
Portable accredited training program, on-going professional support and connection of trainees to a professional link serve are essential for dissemination and adoption of best practices.