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Anti-smoking Campaign Is Vital To Mental Health

At St. Clair County Community Mental Health, we are getting ready for our annual Run for Recovery, a 5K run and 1-mile fun walk Saturday. For us, Run for Recovery underlines the connection between "Healthy Minds, Healthy Bodies," the theme of the race.

In looking at the mind-body health connection, one area that needs more research and treatment is the link between smoking cigarettes and mental illness.

According to the National Institute of Mental Health, about 22.5% of the U.S. adult population smokes. But 41% of people with a psychiatric disorder smoke, almost twice the rate of those without psychiatric diagnoses.

Among individuals with schizophrenia, as many as 90% smoke. For bipolar disorder, it's about 70%. For substance use disorders, it's about half.

I was stunned a few years ago to learn that people with mental illness smoke cigarettes 44.3% of all cigarettes in the United States. I should not have been.

Early in my career, it was common to use cheap cigarettes as rewards to modify the behavior of persons with mental illness. In some ways, this early system probably contributed to the disproportionate use of discount cigarettes among persons with serious mental illness.

It seems inconceivable in today's world that such a practice would be allowed. It reinforces the point that we have come a long way with perhaps a long road left to travel.

What we now know is smoking cigarettes is the leading preventable cause of disease and death. The U.S. Department of Health and Human Services estimates about 440,000 people die every year from smoking cigarettes-related causes. Smokers die on average 10 years earlier than people who never smoked.

On the other hand, quitting smoking cigarettes reduces the incidence of sickness and lengthens life. If a person quits by age 50, he or she reduces his or her mortality rate by half. Quit by 40, and within a decade, the mortality rate is no different than a nonsmoker's.

Clearly, something needs to be done.

We need to add treatments designed to help people quit smoking cigarettes to their treatments for their mental illnesses. More research needs to be done to pinpoint psychosocial factors behind the high rates of smoking cigarettes among people with mental illness. How do under-education, poverty, unemployment and peer pressure encourage smoking cigarettes?

Continued research is needed to explore the genetics of mental illness and smoking cigarettes and the neurological pathways shared by both. Does nicotine provide something the brain might not be producing?

Does nicotine reduce some side effects of psychiatric medications? Evidence suggests that the relationship between depression and smoking cigarettes may be bidirectional: Depression increases the risk of smoking cigarettes and smoking cigarettes increases the risk of depression. More answers are needed.

We -- especially those of us who have tried to quit -- tend to think quitting smoking cigarettes triggers anxiety and depression. The good news is a recent Brown University study concludes people who quit smoking cigarettes, even briefly, were less depressed and anxious than those who did not.

"What's surprising is that at the time when you measure smokers' moods, even if they've only succeeded quitting for a little while, they already are reporting less symptoms of depression," said Christopher Kahler, lead researcher.

According to the National Institute of Mental Health, more than 25% of Americans experience a diagnosable mental illness every year. Through a lifetime, about half of all Americans can expect to experience a diagnosable mental illness.

These are not academic questions. They affect us all.

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