JAMA: Smoking rates in mentally ill still high despite big declines overall

Ziedonis says focus on smoking cessation rising in mental health treatment

By Bryan Goodchild and Sandra Gray

UMass Medical School Communications

January 07, 2014

Adults with mental illness are quitting smoking at a far slower pace than the general population according to a new study published in the Jan. 8 issue of the Journal of the American Medical Association.

“Unfortunately, despite the progress in the general population of reducing smoking by about 50 percent, we have not seen that in the mentally ill population,” said UMass Medical School psychiatrist and tobacco addiction expert Douglas Ziedonis, MD. The study , which he was not involved in, found that while smoking rates declined significantly from 2004 to 2011 among individuals without mental illness, they did not change significantly among those with mental illness.

Dr. Ziedonis, professor and chair of psychiatry, cited more grim statistics: People with mental illness smoke at about twice the rate of those without—about 44 percent of the cigarettes consumed in the U.S. are by people with mental illness. In Massachusetts, people with serious mental illness have a 25-year-shorter life span, much of that attributed to smoking. People in addiction recovery have a 12-year-shorter lifespan if they also are smokers.

”Oftentimes, people with mental illness are concerned about stress and weight gain when they quit, not that others aren’t, but this group seems to be particularly focused,” noted Ziedonis, whose research has focused on addiction, particularly to tobacco, in the mentally ill.

However, he debunks the idea that individuals with mental illness self-medicate with tobacco.

“I think first it’s an addiction,” he said. “Second, there’s the concern a patient has when they’re trying to quit about stress that keeps them in the addiction.”

But Ziedonis does find reason for optimism.

“Nowadays we’re much more focused on wellness in recovery and also looking at the physical health of individuals who have mental illness,” he said. “This recent paper was important in finding out that quit rates were actually better for people who attended mental health treatment. Mental health treatment providers are now realizing that they need to better address tobacco and wellness issues.”