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Archive for Monday, November 11, 2013

Health advocates want to reduce smoking among the mentally ill

November 11, 2013

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Smoking rates in America have fallen dramatically over the past few decades. But while that's true for the general population, it's not the case for all demographic groups.

That's why the Kansas Health Foundation recently started an effort to decrease tobacco use among a group that smokes more than any other: people with mental illnesses.

Kansans with mental illnesses are twice as likely to smoke as the general population, according to Jeff Willett, vice president for programs at the Kansas Health Foundation and co-author of a recent paper on the topic in the Journal of American Medical Association Psychiatry. They also consume more tobacco, accounting for one out of every three cigarettes smoked across the state. People with serious mental illnesses die an average of 25 years earlier than everyone else, largely from treatable conditions such as nicotine addiction and obesity, according to the National Association of State Mental Health Program Directors.

"The paper is really a call to action for the mental health and public health communities to address the issue of tobacco use among people with serious mental illness," said Willett. "Preventing and reducing tobacco use is one of the key goals of the Kansas Health Foundation. In order to achieve our goal of reducing tobacco use … we have to make progress with that population."

Even though smoking rates are down, tobacco use is still the leading cause of preventable death in Kansas, taking the lives of one in seven people per year. Last year, more than 3,600 Kansans lost their lives from tobacco use. "54,000 Kansas children alive today will ultimately die of a tobacco-related disease," Willett added.

Tackling the issue of smoking among the mentally ill won't be easy. Cigarette use has at times been accepted in the mental health community as a stress reducer or a way to reward patients for complying with treatment. In addition, kicking the nicotine habit can be difficult for people already struggling with a mental illness.

"If you are coping with some overwhelming problem in your life, to cope with the withdrawal and problems associated with quitting smoking just adds to that," said David Johnson, CEO of Bert Nash Community Mental Health Center in Lawrence. He acknowledged that something needs to be done to address the problem. "Among those people that we serve who have a serious and persistent mental illness, the prevalence (of tobacco use) is high."

Bert Nash has been taking a more holistic approach recently, including partnering with Heartland Community Health Center to give its patients access to primary care providers. "The whole issue of improving people's health is something we are very committed to. Smoking cessation needs to be a piece of that," Johnson said.

At the state level, the Kansas Health Foundation is bringing together a range of stakeholders, from mental health to tobacco control, to come up with solutions for reducing smoking rates among the mentally ill.

A combination of medication and counseling can help people with mental illnesses overcome their addictions to nicotine, said Kimber Richter, associate professor of preventive medicine and public health at the Kansas University Medical Center.

"The challenge is really how to get treatment to people with mental illnesses and substance abuse problems," she said, noting that the two groups put together account for half of all cigarettes smoked in the U.S. "How do you get the whole system to start thinking about tobacco?"

Comments

James Canaday 5 months ago

Kansans with mental illnesses are twice as likely to smoke as the general population, according to Jeff Willett, vice president for programs at the Kansas Health Foundation and co-author of a recent paper on the topic in the Journal of American Medical Association Psychiatry . They also consume more tobacco, accounting for one out of every three cigarettes smoked across the state. People with serious mental illnesses die an average of 25 years earlier than everyone else , largely from treatable conditions such as nicotine addiction and obesity, according to the National Association of State Mental Health Program Directors.

@duh! needed studies to show this? cigs are indeed just one form of self medication.

instead of this emphasis, how about instead trying to dramatically improve access and continuation of mental health treatment for those who need it, then the addictions can be addressed. this seems like putting the cart before the horse!

yes, the mentally ill die younger, again @duh. suicide is often a complication of mental illness. also, cig use is just one of dozens of poor health behaviors, or failures to engage in good health behavior, by the mentally disordered.

often just symptomatic of a lack of hope.

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Addie Line 5 months ago

I guess I'm just saying schizophrenia, which affects about 1% of the population is one in many on the long list of mental illnesses. There are also high functioning schizophrenics. But I am aware it's a diagnosis that is common to have individuals non-compliant with treatment plans. That still leaves a large group of people who would fall into the mentally ill category that likely aren't needing to get court ordered medication treatments and have the right to self determination.

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Addie Line 5 months ago

So an extreme and specific situation. Okay.

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Addie Line 5 months ago

^^Guess I don't see the "problem" of trying to convince anyone of anything because last time I checked, unless someone needs a legal guardian, "they" have the right to do whatever they want just like anyone else. Even when someone has a guardian you can't shove pills down their throat, despite your opinion that it may be in their best interests. All you can do is educate and allow people to make the choice best for them. That's anyone's right, regardless of not only mental illnesses but physical illnesses as well.

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Leslie Swearingen 5 months ago

Is it possible for people to have a serious mental illness and not be lower class? It used to be said that a lady gets her name in the paper only three times, when she is bred, wed, and dead. I think that is still true today and we are only going to read about lower class or homeless when they get in trouble. I think that extremely poor buy pouch tobacco and roll their own.

Would anyone advocate that these people get free nicotine patches?

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John Graham 5 months ago

The term "serious mental illness" is repeatedly used by not defined. There are many mental illnesses that could be considered serious, and frequently decreased insight and ability to reason are part of the symptom complex. Good luck in trying to explain to them why they should stop smoking and actually having them follow through. It is often nearly impossible to get them to follow through in taking their medication. While a noble idea, the successes will be few and far between.

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Clark Coan 5 months ago

I don't believe they die 25 years earlier as cigarette smokers die only 6-10 years earlier than nonsmokers. I understand that cigarettes calm the nerves of some mentally ill.

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Terry Lee 5 months ago

With the cost and known health damages of cigs you have to be mentally ill to continue to smoke these days .....

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