Academic journal article Health and Social Work

The Lived Experiences of Tobacco Use, Dependence, and Cessation: Insights and Perspectives of People with Mental Illness

Academic journal article Health and Social Work

The Lived Experiences of Tobacco Use, Dependence, and Cessation: Insights and Perspectives of People with Mental Illness

Article excerpt

Although smoking rates among the overall population have declined dramatically since the 1960s, when Surgeon General Luther Terry first announced that smoking was deleterious to health (Schroeder, 2005), smoking rates among people with mental illness remain extremely high (Lamberg, 2004). People with serious mental illness (SMI), commonly referred to as "mental health consumers," have been found to live 25 fewer years on average than do people in the overall population, and this disparity in longevity has been found to be a result of preventable and treatable causes of disease, disability, and death such as smoking (Colton & Manderscheid, 2006; Lutterman et al., 2003; Parks, Svendsen, Singer, & Foti, 2006). Estimates suggest that individuals with mental illness or substance use disorders smoke 44.3 percent of the cigarettes consumed in the United States (Lasser et al., 2000). In fact, tobacco addiction is the most common cooccurring disorder for people with SMI (Ziedonis, Williams, & Smelson, 2003). Approximately 200,000 of the 443,000 people who die prematurely from smoking each year are people with mental illness or substance use disorders (Schroeder, 2009;Williams & Ziedonis, 2004).

Studies indicate that individuals with mental illness or addictions are two to three times more likely to be tobacco dependent than are individuals in the general population (Ziedonis & Williams, 2003). Numerous physiological, social, and cultural factors can contribute to these high rates, including the fact that mental health providers often have limited training in addressing tobacco use and sometimes assume that people with mental health problems cannot quit smoking or that symptom management should take precedence over preventive health measures (Williams & Ziedonis, 2004).Tobacco use is typically ignored or even encouraged in mental health settings and is not deemed a disorder like other mental illnesses or addictions (Williams & Ziedonis, 2004).

Overall, it appears that a complex combination of biological, psychological, and social-cultural factors lead to the high tobacco use and addiction rates among people with mental illness (Schmitz, Kruse, & Kugler, 2003). Several biological hypotheses exist regarding the high rates of tobacco use in this population, although questions remain about causation in the association between nicotine dependence and psychiatric comorbidity. It is possible that there are separate, specific causal mechanisms behind the association between smoking and mental disorders and that between mental disorders and smoking (Schmitz et al., 2003). Furthermore, it is possible that people who have difficulty coping with stress, anxiety, and depression are more susceptible to nicotine dependence, as it may temporarily relieve feelings of tension. Yet such a dependency may create a vicious cycle, because the inability to quit smoking is itself stressful and can lead to greater anxiety (Schmitz et al., 2003). In terms of social and cultural factors, smoking has become an accepted and integral part of the culture in mental health and substance abuse treatment centers and is often considered a common collective social practice within these settings.

QUITTING SMOKING AND MENTAL ILLNESS

Be that as it may, studies suggest that people with mental illness can quit smoking and have high motivation to do so. Prochaska et al. (2004) found that almost 80 percent of depressed smokers wanted to quit, and nearly one in four were ready to quit in the next month. Individuals do not need to be free of mental illness symptoms to quit (Schroeder, 2009), and research suggests that individuals being treated for depression can quit smoking without adversely affecting their mental health (Prochaska et al., 2007). The overall rates of quitting among people with mental illness are substantial, but they remain lower than that in the population overall (el-Guebaly, Cathcart, Currie, Brown, & Gloster, 2002). …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.