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With increasing general awareness about the ill-effects of smoking, many smokers have quit. While more than 50% of the smokers have given up on smoking, only 34% of mentally ill Americans have done so. Find what is preventing them from quitting smoking.

Due to sustained efforts by the government and introduction of multiple awareness programs, the prevalence of cigarette smoking has reduced considerably all over the United States. However, in certain specific sub-populations, like persons with mental illness, the prevalence of cigarette smoking still remains pretty high. This has been revealed in the recent issue of Vital Signs, a weekly published by the Centers of Disease Control and Prevention.

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Tobacco is one of the leading causes of mortality and morbidity in the U.S.

It accounts for 443,000 premature deaths annually. Apart from the deaths, it can cause multiple diseases like diseases of the cardiovascular system, cancers, lung diseases, affliction of the mother and her fetus during pregnancy and exacerbation of pre-existing chronic illnesses.

Tobacco related diseases are a huge drain on the state exchequer too

Treating such ailments costs America $96 billion in direct medical expenses every year. It also costs $97 billion as lost productivity annually. Keeping in mind these factors, the state has formulated the “healthy people 2020 target” of reducing the prevalence of cigarette smoking in adults to ≤12%.

But the latest report, compiled by the 2009-2011 National Survey on Drug Use and Health (NSDUH) has found that

while the national average of current smoking in adults above the age of 18 without any mental illness was 21.4%, the prevalence of smoking in people suffering from any mental illness was 36.1%.

It was seen that almost 19.9% of American adults (45.7 million) above the age of 18 suffered from some kind of mental ailment. Of all the cigarettes smoked by adults aged ≥18 years, 30.9% were smoked by adults with a mental illness. When the population of current smokers was considered, it was seen that adults who did not suffer from mental illness smoked 310 cigarettes in the preceding month compared to 331 cigarettes by people who had any mental illness. Even when comparing the rates of quitting, people with mental illness lagged behind. The quit ratio among adults without mental illness was found to be as high as 53.4% compared to 34.7% in people with mental illness.

Among people with mental illness, the prevalence was higher in men (39.6%) compared to women (33.8%). It was highest in men in the age group of 18 to 24 (41.6%) compared to men above the age of 65 (13.0%). When ethnicity was taken into account it was seen that the prevalence of cigarette smoking was the lowest in Asian men (20.6%) and the highest in whites (37.7%). But Asian men with mental illness were twice as likely to be smokers compared to Asian men without mental illness. In Asian women, this difference was three times. It was also noticed that the prevalence of smoking was higher in adults living below the federal poverty levels (47.9%). When adults with any mental illness above the age of 25 were considered, the prevalence of cigarette smoking was the lowest among college graduates (18.7%).

The lowest prevalence of smoking was noticed in the West and the Northeast. States with lowest rate of prevalence of smoking did so by implementation of comprehensive tobacco control programs and several population based interventions. Certain states promoted Medicaid coverage to cessation treatments in order to remove the cost barriers.

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