Smokers who are mentally ill smoke more cigarettes

Published on June 12, 2008 4:25 AM

According to Steven A. Schroeder, director of the Smoking Cessation Leadership Center, smokers who are mentally ill smoke more cigarettes and have more trouble quitting than people with no mental illness. Also the rate of tobacco smoking is much higher among those with mental illness than among the general population.

Standard definitions of mental illness include major depression, bipolar disorder, agoraphobia, social and simple phobia, generalized anxiety disorder, alcohol abuse and dependence, antisocial personality, conduct disorder and non-affective psychosis.

Statistics show that in the United States, between 50 and 80% of all people with mental illness are smokers, whereas only 20% of the general population smokes. Those with mental illness also smoke more cigarettes per day than other smokers, and are more likely to smoke cigarettes all the way down to the filters. The combination of these two factors means that 44 percent of all cigarettes sold in the United States are sold to people who are mentally ill.

Those who are mentally ill also have more trouble quitting, succeeding at less than half the rate of the general population.

The high rate of tobacco use among the mentally ill is thought to contribute substantially to the lowered life expectancy among that population, people with mental illnesses die an average of 25 years sooner than the general population.

Among the general population, smokers die an average of 10 to 15 years earlier than non-smokers. Approximately 440,000 people die of smoking-induced causes in the United States every year.

According to Schroeder, part of the reason for the prevalence of smoking among the mentally ill is that mental health hospitals have a long tradition of using cigarettes as a way to control patients, proffering smoking breaks as rewards and withholding cigarettes as punishment.

This study does not really explain why persons with mental disorders smoke more than others. It is not known yet whether nicotine is a stimulant, and whether it seems to ease the symptoms of some severe disorders such as schizophrenia.

65-90% of persons with schizophrenia are nicotine dependent, probably partly because nicotine relieves some of their symptoms and improves cognitive functioning.