Smoking: Serious and Plentiful Challenges

As the smoking statistics imply, there are many additional challenges for people with mental illness who wish to quit. For one thing, they smoke “harder” than their counterparts (e.g., smoke more of the cigarette) and they begin smoking  earlier.  They lack of confidence about their life and about their chance of quitting.  And are more likely to make unaided quit attempts without benefit of evidence-based treatment.

The above are serious and plentiful challenges – did I mention high stress and lack of support? But there are more…..some people with mental illness receive an “unhelpful” response from their health care providers. The professional can say “it’s not in the scope of my job” (to help someone stop smoking). Few professionals identify and document smoking status,  and some say…”I don’t know how important ths is for the health of my patient”……,  Many conclude/assume their patients don’t want to quit (UW-CTRI reported on a study where 83% of smokers have tried to quit.)

In addition, some providers feel that trying to quit will harm the patient (for example, de-stabilize the person, or “now is not the time – we’ll do it later”) or don’t know how important smoking cessation is. Then there is also the belief or thought that …smoking is one of the few pleasures my patient has…. And lastl,” I don’t know how to help”, “I don’t have time” and “I don’t know how to bill for tobacco dependence treatment”.(Poor things!)

Dr Bruce Christiansen PhD, Lead Researcher at the University of Wisconsin’s Center for Tobacco Research and Intervention states “Those with significant mental illness who smoke need treatment of greater intensity than the typical smoker while currently they are getting far less, resulting in a considerable treatment gap.”