Smoking and Mental Illness

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The Smoking Cessation Leadership Center recently had a fascinating, although alarming, web symposium that highlighted the link between cigarette smoking and mental illness. The most important message was that smokers with mental illness are becoming a sizeable percentage of those who continue to smoke in the United States.

Among the highlights from the discussion:

  • More than 1 in 3 adults (36%) with a mental illness smoke cigarettes, compared with about 1 in 5 adults (21%) with no mental illness.
  • About 3 of every 10 cigarettes (31%) smoked by adults are smoked by adults with mental illness.
  • Smoking-related diseases such as cardiovascular disease, lung disease, and cancer are among the most common causes of death among adults with mental health conditions.

What’s more, the prevalence of smoking among those with a serious mental illness is not decreasing. According to the National Health Interview Survey (NHIS), an annual study conducted by the Centers for Disease Control and Prevention (CDC), in 2011 42% of adults with a serious psychological distress status smoked cigarettes, about the same percentage as in 1998. No wonder smoking is the number one cause of death in people with mental illness or addiction.

The panel of experts, which included Dr. Corinne Graffunder, Director of the Office on Smoking and Health at the Centers for Disease Control and Prevention, and Dr. Jill Williams, Director of the Division of Addiction Psychiatry in the Department of Psychiatry at the Rutgers Robert Wood Johnson Medical School, had a number of suggestions for local communities to consider. In the first place, they stressed the importance of challenging the perception that smoking helps with anxiety and depression, which of course it does not, and informing smokers about the mental health benefits associated with quitting.

Just increasing awareness of high smoking rates among those with mental health conditions, and providing factual information about smoking cessation, will help. Currently, only 1 in 4 mental health treatment facilities offers quit smoking services. That has to change. We know that smoking inhibits recovery from illnesses, from being financially stable, from finding and holding a job, and from securing housing. These issues are only exacerbated among the mentally ill.

The Smoking Cessation Leadership Center is encouraging healthcare and mental health professionals, including pharmacists, to include tobacco cessation treatment as part of their overall mental health treatment. Targeted efforts are needed to increase quit attempts and cessation rates. The Center offers outreach materials specifically aimed at this vulnerable population, including print ads, editorial content, digital banners, ad web content, and a downloadable poster; quit guide, and toolkit. Visit for more information.


Keith Vensey
Director of the Geographic Health Equity Alliance

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