” When I first started smoking, I thought I was cool. Then I stopped. When I picked up smoking several years later, it was a way to get high. Then I stopped. It wasn’t until I found myself in recovery that I really started smoking like a chimney. My parents were concerned and frankly annoyed my this new habit. There was a sense of relief however, when they discovered in their NAMI class (National Alliance on Mental Illness) that this was commonly seen in people who have mental disorders and addiction. So I went on their website and found the article that explains it all! So if your a smoker, you may relate to this bit of text! It does focus on mental illness but a lot of the information can be useful to all.” -Peace, Robyn
Smoking and Mental Illness
People living with mental illness have a very high rate of smoking. A study by The Journal of the American Medical Association reported that 44.3 percent of all cigarettes in America are consumed by individuals who live with mental illness and/or substance abuse disorders. This means that people living with mental illness are about twice as likely to smoke as other persons.
A positive note is that people who live with mental illness had substantial quit-rates, which were almost as high as the group without mental illness. NAMI has led many changes in our mental health system─getting access to the tools to quit smoking is a way to improve the quality and quantity of life. Improving lives is a new advocacy pursuit.
The Connection between Mental Illness and Smoking
There is no one single, certain reason why so many people who live with mental illness smoke. It may be a combination of brain effects, psychological effects and the social world in which we live.
From a brain-based perspective, research is being done to determine if and how nicotine is involved in some of the brain’s memory functions. If nicotine is a factor, then this could explain why so many people living with an illness like schizophrenia or other illness involving cognitive deficits may smoke. Even though smoking is thought to enhance concentration and cognition, the effects are short in duration.
Researchers and the medical community have a great deal to learn about how smoking impacts the brains of those living with mental illness. It is known that people diagnosed with schizophrenia often smoke before the onset of symptoms and that they smoke more often and inhale more deeply than smokers without schizophrenia.
While we still have a lot to learn about why people smoke, there is plenty of information to support the serious health risks of smoking. So while there may be good reasons why you were attracted to smoking, the key is to figure out ways to increase rates of quitting. Nicotine isn’t a health problem on its own, but when smoked and combined with hundreds of other chemicals that are present in cigarettes the practice of smoking is toxic.
Psychologically, all addictions soothe cravings. People often find themselves relaxed and less tense when their addiction is fed. This is true of cigarette smoking. Smoking can also be part of a social norm, one where people in your social circle all hang out and smoke. Some people who live with mental illness learned to smoke in a hospital or in group-living settings. These examples help illustrate how the mental health culture needs to move forward to reduce the tie between socialization and smoking.
Facts About Smoking
People die from smoking-related illnesses. Every year, smoking kills about 200,000 people who live with mental illness. Smoking harms nearly every organ of your body and diminishes your overall health. Smoking is a leading cause of cancer and of cancer-related death.
Smoking also causes heart disease, stroke and lung disease. With the increased risk of heart disease from second-generation atypical antipsychotic medications (SGAs), individuals living with mental illness must try to quit.
Inhaled cigarette smoke is made up of 4,000 chemicals, including cyanide, benzene, ammonia and carbon monoxide to name a few. There is no safe tobacco product, so switching to a smokeless or chew product will not eliminate your risk of smoking-related diseases.
People are finally waking up to the fact that smoking is a true health hazard, and people need to quit in order to live longer. More psychiatric facilities are going smoke-free, and NAMI is advocating for access to smoking cessation in outpatient settings.
State mental health commissioners and state medical directors are committed to changing the way the public mental health culture relates to smoking. Check out their toolkit (http://www.nasmhpd.org/general_files/publications/NASMHPD.toolkitfinalupdated90707.pdf) to see what policy changes and strategies they are using to create a healthier mental health system environment.
Smoking’s Effects on Symptoms and Medications
Research shows that people living with mental illness do not have worse symptoms after they quit. It is understandable that this is a concern with quitting smoking. Quitting is hard work, and it may take many efforts to be successful. Be sure to get support, talk with your doctor, set a quit date and explore the tools for success (Link to tools for success section) that are available to help you quit.
If you are a smoker and you quit, you can usually get the same treatment results from lower doses of psychiatric medications. Smoking increases the breakdown of medicines in your body, so smokers need to take higher doses to get the same results as someone who does not smoke. Without cigarettes you may need to take less medication. An additional benefit is that a dose reduction will likely reduce side effects of medicines, such as weight gain and other side effects.
Holistic Recovery from Addiction 