NYAPRS Note: New data underscoring the tremendous importance of re-doubling efforts to seriously expand smoking cessation supports for people with psychiatric conditions. Given the close ties between idleness and smoking by people who’ve been routinely told for decades that they can’t work, this also emphasizes the importance of employment and related supports.
Mentally Ill Adults Smoke Much More, Study Finds
ByTimothy W. Martin Wall Street Journal February 5, 2013
More than a third of adults with mental illness smoke, a rate that is about 70% higher than those with no mental illness, according to a government report released Tuesday.
Adults with mental illness are more likely to be heavy smokers and to have picked up the habit at an earlier age than smokers without such illness. They are also less likely to succeed at quitting, according to the Centers for Disease Control and Prevention, co-author of the report with the Substance Abuse and Mental Health Services Administration.
The findings, compiled from SAMHSA's national surveys from 2009 to 2011, spotlight a widening gulf in adult smoking rates between people with and without mental illness. The CDC says the study illustrates the need for broader adoption of smoking-cessation programs.
"Contrary to perceptions, smokers with mental illness want to quit," said Doug Tipperman, a tobacco prevention official at SAMHSA.
Researchers classed adults as having a mental illness according to their answers to questions based on two scientific measures of psychological distress and other social factors. The determination wasn't based on whether a person had been clinically diagnosed.
About 36% of adults with mental illness smoke, compared with 21% of adults with no mental illness, the CDC said. About 46 million American adults-or nearly one in every five-have a mental illness or serious psychological distress, like schizophrenia, phobias or depression, according to the CDC.
Smoking rates for people with mental illness could improve with additional counseling, longer cessation programs or increasing the number of tobacco-free campus policies at mental-health facilities. "What we generally find are the treatments work, but they're not applied as well as they should be," said CDC DirectorThomas Frieden.
Mental-health facilities have been reluctant to help patients quit smoking, over fears it would interfere with treatment.
Smoking rates among those with mental illness were higher for young adults and Native Americans, as well as people with lower education levels and incomes below the poverty line, the CDC said. The report analyzed a nationally representative sample of more than 67,000 Americans aged 12 or older.
Tobacco use is the leading cause of preventable disease and death, according to the CDC.
People With Mental Illness More Likely to Be Smokers, Study Finds
ByPam Belluck New York Times February 5, 2013
People with mental illness are 70 percent more likely to smoke cigarettes than people without mental illness, two federal health agencies reported Tuesday.
New datafrom theCenters for Disease Control and Preventionand the Substance Abuse and Mental Health Services Administration show that one of every three adults with mental illness smokes, compared with one in five adults without mental illness.
Adults with mental illness smoke about a third of all the cigarettes in the United States, and they smoke more cigarettes per month and are significantly less likely to quit than people without mental illness, the report said. There are nearly 46 million adults with mental illness in the United States, about a fifth of the population.
“Many people with mental illness are at greater risk of dying early from smoking than of dying from theirmental healthconditions,” said Dr.Thomas R. Frieden, director of the Centers for Disease Control, during a press briefing.
The report is based on information from the National Survey on Drug Use and Health, which interviewed 138,000 adults in their homes from 2009 to 2011. People were asked 14 questions to assess psychological distress and disability, and were deemed to have mental illness if their responses indicated they had a mental, behavior or emotional disorder in the past 12 months. Those withsubstance abuseor developmental disorders were not considered people with mental illness. The report did not include patients in psychiatric hospitals or individuals serving in the military.
People who reported smoking all or part of a cigarette in the previous 30 days were counted as smokers.
The study found that smoking rates for people with mental illness were generally higher in states where overall smoking rates were high. Utah had the lowest rate of smoking among people with mental illness - 18.1 percent - while West Virginia had the highest rate, at 48.7 percent. Smoking among people with mental illness was higher among the poor and less educated, and among American Indians and Alaska Natives, although every ethnic group had significant percentages of smokers.
The study noted several possible reasons that smoking among the mentally ill has been and remains high, including marketing by the tobacco industry and the historical use of cigarettes as an incentive to improve behavior in psychiatric hospitals.
“There are some effects ofnicotinewhich can mask some of the negative effects of mental illness,” Dr. Frieden said. The study said that smoking can also make some medications less effective, which may then lead the person with mental illness to smoke more to quell symptoms. And it said that people with mental illness, many of whom struggle to live a financially and socially stable life, may be less able to cope with withdrawal symptoms from quitting cigarettes.
While the study did not compare trends in smoking among people with mental illness over time, Dr. Frieden and Douglas Tipperman, lead public health adviser on tobacco prevention for the Substance Abuse and Mental Health Services Administration, cited indications that smoking rates for this population have not declined nearly as quickly as smoking in the general population. Dr. Frieden called the situation “a very serious health issue that needs more attention.”
Mr. Tipperman said a recent survey in New York showed that smoking rates among people with mental illness had not changed significantly over the past decade.
Still, Mr. Tipperman said that surveys show that many people with mental illness want toquit smoking, and can quit successfully with the right approaches, which may include extra antismoking counseling or longer use of smoking cessation medications. His agency has been working to establish and encourage smoking cessation programs that work.