COUNTY OF SAN DIEGO HHS

   
  Mental Health, Recovery and Quitting Smoking
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  Nicotine addiction
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  An Emerging Deadly Trend: Waterpipe Tobacco Use
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...County of San Diego Health and Human Services

...TOBACCO CONTROL PROGRAM

   
 

 

PAGE 1

Mental health

.....Recovery and

Quitting Smoking

 

"I didn’t recover from depression, drugs and alcoholism to die from emphysema, I have to Stop Smoking!"

....Smoking among patients with mental illness and addictions is a major and underappreciated public health problem. This has been a “silent” epidemic facing the challenges of the stigma associated with mental illness and addictive disease.

....New explanations for the link between cigarette smoking and mental illness are emerging. A research found that forty-one percent of current smokers report having a mental health diagnosis in the past month, 60% report a mental health diagnosis at some point in their lifetime, and among current smokers, the most common mental health diagnoses are alcohol abuse, major depressive disorder, anxiety disorders, and illicit drug use or dependence.The more severe the psychiatric symptoms, the more likely the patient is to be a smoker, and quitting cigarettes requires long-term planning, impulse control and the ability to perso- nalize risk -- all that much harder to do when one's thinking is impaired by mental illness.

....Smoking by teens may well signal the fire of alcohol and other drug abuse and mental illnesses such as depression and anxiety disorders. Teens who start smoking early are more likely to report symptoms of mental illness such as hopelessness, depression and worthlessness.

....According to research by The National Center on Addiction and Substance Abuse (CASA) at Columbia University, because nicotine significantly affects the structural and chemical changes in the developing brains of adolescents, smoking cigarettes makes teens more vulnerable to alcohol and drug addiction and to mental illness. Analyzing data from the National Survey on Drug Use and Health (NSDUH), CASA researchers found that teens who smoke are nine times more likely to meet the medical criteria of alcohol abuse or dependence, and 13 times more likely for abuse and dependence on an illegal drug, compared with teens who don't smoke. The report is titled, Tobacco: The Smoking Gun.

...."These findings sound an alarm for parents, teachers, pediatricians and others responsible for children's health that smoking by teens may well signal the fire of alcohol and other drug abuse and mental illnesses such as depression and anxiety disorders," said Joseph A. Califano, Jr., chairman and president of CASA in a news release. "We have known for a long time that smoking causes deadly and crippling cancers and cardiovascular and respiratory diseases. Now we see the devastating effects that nicotine can have on the developing brains of our children and teens." “This report underscores what we know about the developing brains of teens who are highly vulnerable to personal, social and media influences to begin smoking and why it is so vital to reach them with information and education about tobacco before they start to smoke.”

....Recent studies suggest that quitting is possible for this population with combination treatments, including use of motivational techniques as well as combinations of medications and behavioral therapy.

....Mental health clinicians have tended not to address smoking cessation with their patients, but increasing evidence suggests that such reticence is unwarranted, as smoking cessation in this population is feasible. The approach to cessation should include standard interventions of counseling and pharmacotherapy, for which substantial evidence of efficacy exists in patients with and without mental illness. If patients with mental illness are to achieve wellness, smoking cessation must be an integral component of their treatment regimen. Counseling should emphasize the continuing benefits of quitting as well as devise behavioral strategies to combat the urge to smoke.

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