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Driver diagram for state public health authorities

Author: Cicatelli Associates Inc.

Date: December 2025

Advancing Tobacco-Free Recovery Through Systems Change

The National Center of Excellence for Tobacco-Free Recovery (CoE-TFR) developed this driver diagram to guide multi-sector efforts in transforming systems of care and support to advance tobacco-free recovery (TFR) for individuals with behavioral health conditions (mental health and/or substance use conditions). This tool is designed to help partners across public health, healthcare, behavioral health, and community systems identify
shared goals, align strategies and coordinate sustainable action toward system change.

Public health agencies play a pivotal role in shaping the policy, funding, and infrastructure needed to advance tobacco-free recovery. This driver diagram is intended to support state health departments in aligning leadership, data systems, funding mechanisms, and strategic partnerships to embed TFR into public health priorities and behavioral health transformation efforts.

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