The Smoking Scourge According to the Centers for Disease Control (CDC), 15.5% of Americans 18 years of age and older were cigarette smokers during 2016, compared to 20.9% during 2005. Those who quit smoking increased from 50.8% during 2005 to 59.0% during 2016. The percentage of heavy smokers (20–29 per day) decreased from 34.9% to 28.4%, and the percentage who smoked fewer than 10 per day increased from 16.4% to 25%. Almost a total of 38 million American adults smoke. Smoking was most prevalent among men as well as those with less education, multi-racial and Native Americans, the poor, the disabled, LGBTQI, those without health insurance or with Medicaid coverage and living in the Midwest and South.

Government’s Participation in Stop-Smoking Programs The US Food and Drug Administration (FDA) is planning to propose nicotine reductions in tobacco products in an attempt to reduce tobacco’s addictiveness. The new, proposed limits would potentially reduce the prevalence of smoking to only 1.4% of Americans. The FDA is also launching a new smoking cessation campaign at gas stations and convenience stores to encourage smokers trying to quit to keep trying. More than 55% of adult smokers tried to quit during 2015, but only 7% succeeded, according to the FDA. Kentucky and South Carolina made it easier for low- income persons to receive non-smoking treatments and Indiana, North Carolina and Tennessee increased funding for smoking prevention. West Virginia eliminated and Texas reduced prevention funding.

Enlisting Outside Support for Addiction According to IBISWorld, there were 3,617 substance- abuse businesses in the US during 2017, generating $6 billion in revenues. Revenues increased 4.9% from 2012 through 2017, and revenues and profits are expected to continue to increase through 2022. Hospitals, universities, healthcare systems, states and non-profits offer in-person or online smoking cessation programs, and many of them are free. Approximately half of substance-abuse programs also offer smoking- cessation support. CVS Pharmacy offers smoking-cessation counseling at its Minute Clinics, of which there are more than 1,100 in CVS Pharmacy and Target stores. In addition to counseling, patients can purchase over-the-counter and prescription NRT (nicotine replacement therapy) products.

The Drug Abuse Problem According to the US Substance Abuse and Mental Health Services Administration, illicit drug use increased between 2015 and 2016, from 17.8% to 18.0%, and mostly from marijuana during 2016 (13.5% to 13.9%), as it was legalized in a number of states. Opioid use, including both heroin and pain reliever misuse, decreased from 4.7% to 4.4% from 2015 to 2016. Nevertheless, opioid overdoses increased 30% from July 2016 through September 2017 in 45 states. The Midwest’s overdose rate increased 70%. There were 66,324 reported drug overdoses for the 12 months ending May 2017, an increase of 17% from the previous 12 months, according to the National Center for Health Statistics. Approximately a third of these were from fentanyl and other synthetic opioids.

The Rehab Clinic Industry Substance-abuse rehab facilities have benefited from Medicaid expansion as well as the Affordable Care Act (ACA) that mandates substance abuse coverage and forbids insurance companies from denying coverage or raising rates because of a pre-existing condition. The substance abuse rehabilitation industry is estimated to generate $35 billion in revenues. Since changes in the ACA, the industry, which had been reliant on cash customers, is receiving lower payments from insurance companies. Because more people have access to substance-abuse treatment through the ACA, there has been a proliferation of clinics, many of them unscrupulous, giving the industry a bad reputation.

More Low-T Clinics Are in the Marketplace Between 2003 and 2013, the incidence of testosterone use increased four times among men 18–45, from 29.2 per 10,000 to 118.1 per 10,000. Among men 56–64, use tripled. Only 5% of men between the ages of 50 and 59 have low levels of testosterone, including symptoms, such as loss of sex drive and sluggishness. The FDA approves testosterone gels and shots only for men with levels less than 300. Pharmaceutical companies’ direct-to consumer- marketing drives business to doctors and clinics. The Low T Center has more than 40 locations in 10 states and Texas is home to several testosterone replacement clinic chains. Most clinics are small and independent.

Advertising Strategies Advertising messages from drug rehab clinics should emphasize their acceptance of various forms of health insurance. To combat negative press, testosterone clinics can highlight how they have respected doctors on staff and are focused on a whole-body approach for men’s health. Alcohol and drug rehab facilities and smoking cessation programs and clinics may find it beneficial to offer private screenings to major employers to help employees and retain them following successful therapy.

New Media Strategies Create reformed smokers support groups on Facebook with the involvement of a clinic’s professionals. When people need additional help, they will know to contact your facility. Geo-target areas with concentrations of opioid addiction with local Google listings and Facebook ads. Ask patients and/or local advocates of treatment for these addictions to record short videos for social media posting. Content can be how patients overcame their addictions and why people should not be stigmatized, especially if they are proactively seeking treatment.