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Cigarette Smoking Among People with Serious Mental Illness Continues to Increase

Thursday, March 1, 2018  
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Cigarette Smoking Among People with Serious Mental Illness Continues to Increase  


Cigarette smoking among patients with serious mental illness is alarmingly high, and continues to increase in comparison to people without psychiatric disorders, according to new research.

Past research has shown that cigarette smoking among individuals with serious mental illness is very common, particularly among individuals with schizophrenia. Smoking is a major factor contributing to the premature mortality of individuals with serious mental illness, in which research shows individuals with severe psychiatric diseases die up to 25 years earlier than those without psychiatric diseases.

New research published this month in Psychiatric Services indicates this trend is worsening. Faith Dickerson and authors from Sheppard Pratt Health System analyzed the cigarette smoking status of 1,938 individuals who participated in their research studies from 1999-2016, which included people with a serious mental illness, schizophrenia or bipolar disorder, and control subjects without psychiatric disorders.

Study findings

The findings of Dickerson and her coauthors were striking. Almost two-thirds of the 837 individuals with schizophrenia were current cigarette smokers, more than three times that of those without a psychiatric illness. In addition, more than one-third of individuals with bipolar disorder were current cigarette smokers, two times the rate of smoking among the controls.

Individuals with serious mental illness were also more likely to consume a higher quantity of cigarettes than controls, according to the results.

The results show that the disparity in cigarette smoking between individuals with serious mental illness and the general population is increasing. Although there was a significant decline in the prevalence of cigarette smoking in the controls from 1996-2016, there was no such decline for individuals with schizophrenia or bipolar disorder. The authors argue that the lack of progress in smoking cessation among individuals with psychiatric disease is troublesome, especially as there have been increasing calls to action in recent years by psychiatric leaders to address this disparity. However, there are solutions. Research shows that smoking cessation treatments are effective for psychiatric patients with serious mental illness.

An encouraging finding was that there was a decrease in the amount of cigarettes smoked by psychiatric patients who were smokers over the study period. Although the reasons behind this trend are not clear, this could be due to the increased taxation on cigarettes and resulting higher costs as well as more restrictions in when and where people are allowed to smoke.

Cigarette smoking is the leading cause of preventable mortality in the United States and is known to cause cancer, heart disease, lung disease, diabetes and other disorders. The alarmingly high rate of smoking among individuals with serious mental illness and resulting increased mortality points to the urgent need to address this public health crisis.


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