Smoking Cessation in Mental Health

 In Feature article

People who have a mental disorder are at greater risk of a variety of medical conditions. They experience physical illness more regularly and have a shorter life expectancy compared to those without mental illness. There are various reasons for this, however it is high rates of smoking that exacerbates these health inequalities.

The National Centre for Smoking Cessation and Training (NCSCT) offer great advice on how to help patients give up, and opening up a dialogue with the patient at an early stage can be extremely beneficial in helping them quit. This could save the hospital money on extra drugs and minimise the duration of the patients stay, freeing up more places etc.

The NCSCT state ‘Currently in the UK, approximately 20% of adults smoke. Smoking rates among adults with a common mental disorder such as depression and anxiety are almost twice as high compared to adults who are mentally well, and three times higher for those with schizophrenia or bipolar disorder.’

Also 42% of the tobacco bought in the UK is estimated to be from people with mental health disorders, as they can be more dependent on nicotine. This shows how prevalent smoking is within the mental health sector and why it is so important to help people quit altogether.

Giving up can also be more difficult for someone with mental illness as they often lack the confidence and historically have not been offered the specialist support required to quit. It is much more beneficial for hospitals to help make people give up smoking as there are factors that can affect the mental health institution adversely as well as the patient:-

  • Smoking can cause more severe symptoms of mental health.
  • Can require higher doses of medication e.g. clozapine
  • Smokers tend to spend more time in hospital
  • Smokers have higher suicide rates

There are many benefits to helping mental health patients give up smoking:

  • Improves the respiratory system
  • Nicotine withdrawal symptoms fade, which can help mental health issues
  • The longer patients can last without smoking, the better the chances of symptoms of anxiety and depression reducing
  • Giving up smoking can often be the gateway to better behaviour generally.

The Faculty of Public Health sets out good examples of what needs to happen and what it recommends health services can do to improve smoking cessation in mental health hospitals:-

What needs to happen?
Smoking cessation in people with mental health problems should be made a priority:

  • Specialist cessation treatment provision: specialist cessation services for those with mental illness appear to achieve the best results.
  • Creation of a wider health promoting culture: As well as helping patients become smoke free, other activites should be undertaken to make them healthy in other aspects of their life such as diet.

Recommendations from the Faculty of Public Health: 

  • Education campaigns about the issues of the effects of smoking on mental health.
  • Smoking cessation needs to be carried on when inpatients are then discharged. Support still needs to be provided to prevent relapse.
  • Research needs to take place into smoking cessation amongst those with mental health issues to improve practice. There isn’t much at the moment.


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