I was recently shocked to learn that a friend has taken up smoking, so that she can feel more confident in social situations. This is a very intelligent woman who is otherwise health conscious. She watches her weight, walks for her health and regularly visits her doctor. She had successfully quit smoking years ago, and has now taken it up again.
She is also a person who experiences mental illness, and it is my great fear that she will become another statistic-one of the thousands of individuals who experience mental illness and are addicted to nicotine.
As a non-smoker, I find it hard to conceive of why, in 2009, with all the facts we know about the dangers of smoking, anyone would start to smoke. The facts about individuals with mental illness who use nicotine are particularly ugly:
Why do individuals who experience mental illness smoke more?
Researchers believe that a combination of biological, psychological and social factors contributed to increased tobacco use among persons with mental illness.
Persons with mental illnesses have unique neurobiological features that may increase their tendency to use nicotine, make it more difficult to quit and complicate withdrawal symptoms.
In addition, providers often think that people with mental illness are unable to quit smoking, which is not true. Studies show that people with mental illnesses want to quit smoking and want information about cessation services and resources. Significant evidence shows that smoking cessation strategies work. People with mental illness can successful quit.
Symptom management often takes precedence over preventative health measures. There are clinicians who do not perceive nicotine cessation as a treatment priority, or consider it as too consuming of limited treatment resources.
Historically, patients in psychiatric units were even given cigarettes as a method of reward and control and patients were told that cigarettes could be helpful in their treatment. According to a report by the University of Colorado-Denver, Department of Psychiatry, in the late seventies and early eighties, tobacco companies distributed free cigarettes to homeless shelters, mental hospitals and homeless service organizations. Cigarettes were purchased for persons experiencing mental illness and homelessness, so that these individuals would smoke “clean” cigarettes, not used “butts.”
The tobacco industry also targeted psychiatric hospitals for sales promotions and giveaways.
We talk about the shackles that were used in mental hospitals in the past and the lasting effects of their usage on the national psyche. What of the effects of the knowledge that patients were given cigarettes and encouraged to smoke, when their doctors knew the dangers of tobacco and chose to overlook those dangers in favor of control and submission of patients?
I recently heard a counselor say that he was opposed to a ban on smoking in his consumer-care facility because that is how he builds trust with his consumers-by smoking with them! Imagine if he had said that he built trust through drinking together.
With funding cuts, it is becoming more difficult to find resources for smoking cessation programs. Thousands of individuals who experience mental illness are currently addicted to nicotine and are struggling to find an answer to ending their dependency.
Statistics for this blog was taken from “Smoking Cessation for Persons with Mental Illnesses: A Toolkit for Mental Health Providers”
- --Kristen Frame
Compeer Coordinator
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