The Mentally Ill are Less Likely to Quit Smoking, Study Says

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Although smoking rates have declined in recent years, those numbers do not accurately represent the mentally ill population, according to a new study led by a Harvard Medical School researcher. People with mental illness are nearly twice as likely to smoke then those without mental illness and make up more than half of nicotine-dependent smokers in the U.S., according to the study, which was published in the January 8th edition of JAMA.

“Individuals with severe mental illness have a life expectancy 25 years less than the rest of the population and their high rates of smoking explain a significant amount of this difference,” said Benjamin Cook, an assistant professor of psychiatry at Harvard Medical School and a senior scientist at the Center for Multicultural Mental Health Research at Cambridge Health Alliance. “While the decline in smoking rates in the U.S. is commendable, we have to increase our focus on improving smoking cessation among individuals with mental illness.”

The study used data from 165,269 respondents of the Medical Panel Expenditure Survey, and the authors identified a 20 percent decline in smoking rates for those without mental illness, which is fantastic news. But rates of smokers with mental illness remained steady. Researchers say that the trend persists even after looking into the differences in income, education, and employment.

“Policy efforts to reduce the health burden of tobacco use have been a remarkable public health success,” said the study’s co-author Geoffrey Ferris Wayne, a tobacco control researcher. “That this success has not been realized among those with mental illness suggests the need for different approaches.”

Between 2004 and 2011, smoking rates declined significantly among individuals without mental illness, dropping from 19.2 percent to 16.5 percent. But when it comes to the mentally ill, the rates only dropped from 25.3 percent to 24.9 percent.

Additionally, the researchers found that individuals with mental illness who received mental health treatment within the previous year were more likely to have quit smoking. “There has been a sense in the field that treating nicotine dependence is secondary or may even interfere with mental health treatment,” Cook says. “Our findings suggest that smokers do quit and abstain from cigarettes during mental health treatment. It’s a natural place for practitioners to address nicotine dependence because of the overlap between mental health and cessation therapies.”