Why Is The Prevalence Of Smoking Higher In Mentally Ill Patients?

Researchers tried to analyze the reasons behind the high rate of cigarette smoking and low levels of quitting in the mentally ill population and have come up with several explanations. According to them, this is most likely because of the following factors:

• Nicotine stimulates the central nervous system and can elevate the mood. People suffering from any mental illness are usually depressed and nicotine present in cigarettes can temporarily mask these negative symptoms.

• Certain constituents of tobacco smoke accelerate the metabolism of some medicines used in the treatment of mental illnesses. As these medicines are removed from the blood stream faster, there is an increased compensatory intake of nicotine.
• It has been seen that 80% of the smokers start smoking in their youth. Mentally ill youth who are depressed because of their illness are more receptive to cigarette advertisements and may start smoking.
• People from tobacco industry regularly fund studies which show that nicotine consumption helps in alleviation of mood in mentally ill patients. They provide free or cheap cigarettes to institutions taking care of the mentally ill, and support efforts which try to block actions to make psychiatric facilities smoke-free.
• Persons suffering from mental illnesses often live in stressful conditions and do not have access to means to help them deal with withdrawal symptoms. They may also be ignorant about the deleterious effects of smoking on health.

Researchers have found that psychiatric facilities are also to be blamed for the high rate of prevalence of smoking amongst the mentally ill. They found that:

• Many health care providers felt that withdrawing nicotine would interfere with the treatment of the mentally ill patients.
• Health care providers feel that mentally ill patients who smoke would not like to give it up. They also feel that it would be difficult them to wean these patients off cigarettes.
• Many psychiatric facilities use cigarettes as rewards. The patients are handed out cigarettes as reward for putting up good behavior.

However, researchers say that mentally ill patients are just as inclined to give up smoking as their normal counterparts. The only problem is that helping them quit smoking is a more intensive and long process.

The experts have pointed out that it is our duty to prevent the sub-population of mentally ill from the disastrous consequences of smoking. What is required is a strong will power, sustained efforts to raise awareness, and more collaboration between tobacco control programs and facilities for mentally ill patients at national, state and local levels. Proper integration of tobacco dependence treatment in psychiatric facilities and making policies to make such facilities as smoke free zones would go a long way in helping mentally ill smokers to quit smoking. Continued surveillance to monitor the implementation of these programs and their progress is necessary to make such interventions successful.