The following is an email exchange about smoking and people who experience mental health conditions. The final section was written by MHA's Compeer Coordinator, Kristen Frame.
My understanding is that it is nicotine, rather than tobacco, that positively impacts some schizophrenia symptoms and drug side effects. Does someone in the group have some other information about positive effects from tobacco smoke or other tobacco components for patients struggling with psychosis, etc.? Certainly the negative health effects of tobacco smoke causes other immediate mental and physical issues for people with chronic mental conditions, so eliminating tobacco smoke would be helpful.A daughter who grew up with a mentally ill parent:
I have understood for some time that tobacco helps reduce the incidences and frequency of hallucinations and delusion of a person suffering from debilitating mental illnesses like schizophrenia. If is does, then quality of life should be in the equation. There is no cure for many of our mental illness, only control of symptoms. I ask, if you had to choose, which would you pick.
I do not at all advocate tobacco use, but I feel for the mentally ill patient, there should be some exception to the general rule here.
A suggestion is to reach out to the facility to do training for their staff about smoking and mental illness, harm reduction, and how to support patients in reducing or eliminating smoking. An intermediate step for these particular patients would be to use NRT - lozenge or gum - with these patients rather than chewing tobacco which can lead to oral cancers. And then work with them on use reduction of the NRT.
As you have said, the “positive” effects of tobacco usage are not a justification for not counseling individuals who experience persistent mental illness about the overwhelming evidence that tobacco usage is a significant health hazard and the leading cause of death for individuals with persistent mental illness. There is a short term alleviation of symptoms but like the elusive high of other drugs, it is very short-term and does decrease over time.
This mythology has been perpetuated by outdated “studies” that were funded by the tobacco industry, and debunked by recent more scrupulous current research. A significant portion of individuals who experience mental illness are addicted to tobacco and remain untreated because it is economically advantageous to keep them that way.
Diane writes: “I have understood for some time that tobacco helps reduce the incidences and frequency of hallucinations and delusion of a person suffering from debilitating mental illnesses like schizophrenia. If is does, then quality of life should be in the equation. There is no cure for many of our mental illness, only control of symptoms. I ask, if you had to choose, which would you pick.”
There may currently be no “cure,” but there is recovery and the opportunity for a fully enriched life on one’s own terms. Quality of life is the most important aspect of the equation. Informed decision making is not possible for those who are given inaccurate or misleading information about tobacco addiction. As an advocate, and individual who experiences persistent mental illness, I pick independence and a life constructed of my own informed choices, not reduced to passively accepting a significantly shortened and physically and economically dependent life. We do not accept the notion that alcoholics or other addicts should be supported in the state of addiction because, poor souls, their life is so terrible, we will permit them this vice. Not giving individuals who experience mental illness the up-to-date and appropriate medical treatment that we expect for their peers is not only disabling, it is criminal. Individuals with disabilities do not need to be treated as exceptions, but as equal human beings.
I appreciate your genuine empathy and concern for individuals who experience mental illness. We need equal treatment under the law, not sympathy.
