Newspaper article The Topeka Capital-Journal

Snuffing out Tobacco Use ; Smoking Cessation Project Targets High-Use Populations

Newspaper article The Topeka Capital-Journal

Snuffing out Tobacco Use ; Smoking Cessation Project Targets High-Use Populations

Article excerpt

Topekan Mary Greiner began smoking when she was about 16 years old, and 30 years later, she lit her last cigarette.

"It was mainly a health issue," she said. "I wanted to live, and I didn't want to walk around with an oxygen tank behind me."

The Centers for Disease Control reported in 2015 that smoking in the adult population is at an all-time low of 15.1 percent, so Greiner's story might not be unusual.

But Greiner is a recovering addict and suffers from depression, and that puts her in a group of people who tend to have higher smoking rates.

Data from the National Health Information Survey shows that in 2011, 42.1 percent of people with serious psychological distress smoked, as opposed to 18.2 percent in the population without psychological distress.

In her work as a certified peer support analyst at Valeo Behavioral Health Care, Greiner uses her experiences with mental illness to help others. Now she's prepared to use her experience with smoking cessation as a peer advocate in a new project at National Mental Health Alliance Kansas.

The number of people who smoke and also have mental illnesses is high, and it's a population that Richard Cagan, executive director of NAMI Kansas, said his organization is trying to reach through a new project.

NAMI Kansas received a $300,000 grant from the Kansas Health Foundation as part of a statewide effort to address smoking cessation. NAMI's grant will focus on decreasing smoking in people with mental illness and substance abuse disorders, Cagan said.

"This is not really adequately recognized in the mental health community," he said. "Someone asked, 'Why should we be doing this?' And fundamentally, it's that our people are dying as result of persistent, chronic tobacco use. I think you have tobacco use rates going down overall nationally, but the one population that's sticking out like a sore thumb are individuals with serious mental illness.

"It's not just that our population is smoking at a higher rate and that those numbers aren't going down, but it's also the fact that they're using more tobacco products," Cagan added. "Not just that they're smoking at a higher rate, but they're smoking more and over an extended period of time."

Cagan said it's a myth that it's too difficult for people with serious mental illness to stop smoking.

"Part of this project is to explode those myths. A lot of those myths are perpetrated by family members, by individuals themselves with mental illness and by provider organizations. It's not that many years ago where people were encouraged to smoke as kind of a coping mechanism," he said.

Those myths include the idea that stopping smoking will exacerbate symptoms and add anxiety.

"I think there's ways to get around that," he said. "Plus, the bottom line is, it's going to kill you, plain and simple."

Managing quitting and mental illness

Terra Prescott, a social worker and licensed clinical addictions counselor, works with patients through the Eastern Kansas VA Health Care System in Topeka to help them stop smoking. She agreed with Cagan that the challenges of smoking cessation for those with mental illness can be managed.

Sometimes people become more aware of anxiety or depression symptoms as they quit smoking because they were managing those symptoms with nicotine, she said. They must learn coping skills before they quit smoking, and at the VA she and others work out a pre-abstinence plan and work "slowly" toward abstinence.

"We try out some reduced use, and see what they're experiencing," she said. "From schizophrenia to general anxiety, the symptoms may have been managed with nicotine use. Any type of substance dependence is considered resistance to pain, that's the way we view it in the cognitive behavioral concept. …

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