Smoking is more common among people with mental illness than among the general population (32% versus under 20%). However, that broad statement is too simple for a complex situation. There are significant differences in smoking rates between people with different mental illnesses. Lack of knowledge and ambivalence about addressing smoking in people with mental illness has contributed to this higher rate of smoking which in turn contributes to poorer physical health, premature death and social disadvantage among this already vulnerable group.
Recent research on the impact of quitting smoking on people with schizophrenia and depression has shown that it does not worsen their symptoms and that people with mental illness can successfully quit. There is little data on smoking rates in people with personality disorders. People with personality disorders are at high risk of substance abuse disorders and are therefore at higher risk of being nicotine dependent.
There is strong evidence that advice from clinicians is important in helping people to quit smoking. In mental health this support has been lacking. However, it seems attitudes are changing and it is now clear that ensuring clinicians have the skills and support to address smoking in their mental health clients is an important goal of both individual clinicians and health systems and policies.
Dr Mark Ragg MBBS BA and Dr Tanya Ahmed MBBS Grad Dip Hlth Serv Man