21 May How Often Do Mentally Ill People Successfully Quit Smoking?
Public health officials and mental health experts are quite aware that people affected by various mental illnesses smoke cigarettes at a considerably higher rate than the rest of the general population. In a study published in January 2014 in the American Medical Association journal JAMA, a team of American and Chinese researchers sought to determine if people affected by mental illness successfully quit smoking as often as people not affected by serious mental health issues.
Mental Illness Basics
Mental illness is the general term that doctors and other mental health professionals use to describe conditions that significantly alter an individual’s ability to think clearly, maintain a stable mood, retain emotional control or interact appropriately with his or her surrounding environment. Prominent examples of these conditions include major depression and other depressive disorders, schizophrenia and several schizophrenia-related disorders, anorexia and other eating disorders, personality disorders, bipolar disorders, substance use disorders and anxiety disorders. Some mental illnesses (including schizophrenia, major depression and bipolar I disorder) can produce debilitating changes in an individual’s ability to function independently; experts commonly refer to these conditions as serious or severe mental illnesses. However, all diagnosable mental illnesses produce some meaningful level of day-to-day life disruption.
Mental Illness and Cigarette Use
Nearly 46 million American adults are affected by some type of diagnosable mental illness, the Centers for Disease Control and Prevention report. More than 36 percent of these individuals smoke cigarettes. By comparison, only roughly 19 percent of all adults smoke cigarettes. Smoking rates among the mentally ill are highest for people living in poverty (48 percent) and for men (40 percent). However, the rates among mentally ill women (34 percent) and mentally ill people not living in poverty (33 percent) are still higher than the adult average. Some studies suggest that the majority of U.S. adults addicted to nicotine have a diagnosable mental health disorder.
A mixture of factors likely explains the prevalence of cigarette use among individuals with significant mental health issues. These factors include an overlap in the contributing factors for smoking and mental illness, the common use of smoking as a self-medication tool for the symptoms of various mental illnesses and a tradition of allowing smoking (or even sometimes encouraging smoking) in treatment programs established to address mental illness. Like most adult smokers not affected by a mental health issue, most adult smokers affected by mental illness say that they want to quit smoking and express a willingness to participate actively in smoking cessation efforts.
Smoking Cessation Success
The rate of cigarette use in the general adult U.S. population has been dropping for quite some time. In the study published in JAMA, researchers from Harvard Medical School, the Harvard School of Public Health, Brown University and China’s Southwest University compared the smoking cessation success of people affected by mental illness to the smoking cessation success of people not affected by mental illness. These researchers drew their information from multiple years of two nationwide U.S. projects: the Medical Expenditure Panel Survey (MEPS) and the National Survey on Drug Use and Health (NSDUH). All told, the information gathered from the MEPS project included 133,113 individuals not diagnosed with a mental illness and 32,156 individuals with a mental illness diagnosis. The information gathered from the NSDUH project included just over 14,000 long-term, habitual smokers diagnosed with a mental illness.
The researchers based their comparison on the number of mentally ill and mentally healthy study participants currently smoking cigarettes, as well as the number of people in each group who managed to stay abstinent from cigarette use for at least one month. From 2004 to 2011, the rate of smoking among the participating adults not affected by mental illness fell from 19.2 percent to 16.5 percent. However, the rate of smoking among the study participants with a mental illness only fell from 25.3 percent to 24.9 percent. The drop among the non-mentally ill participants was statistically meaningful, while the drop among the mentally ill participants was not.
Significance and Considerations
The authors of the study published in JAMA concluded that the receipt of appropriate treatment substantially increases the chances that a smoker diagnosed with a mental illness will successfully quit using cigarettes. Slightly more than 37 percent of the treated study participants stopped smoking, while only slightly more than 33 percent of the untreated participants stopped smoking. The authors believe that public health officials and doctors must devise new approaches in order to improve smoking cessation efforts among those diagnosed with a mental illness.
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