Featured Research

from universities, journals, and other organizations

Doctors Fear Asking Mentally Ill To Quit Smoking

Date:
September 9, 2009
Source:
Northwestern University
Summary:
People with mental illnesses such as depression and anxiety are the heaviest smokers in the country, but their doctors are afraid to ask them to quit. They assume if their patients try to quit, their mental disorders will get worse. That is a myth, according to a tobacco addiction specialist. This population's tobacco use needs to be treated, he says.

People with mental illnesses such as depression and anxiety are the heaviest smokers in the country, but their doctors are afraid to ask them to quit. They assume that if their patients try to quit smoking, their mental disorders will get worse.

That is a myth, according to Brian Hitsman, a tobacco addiction specialist and assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine. He also is a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

This population's tobacco use and dependence need to be treated, he said. Hitsman has designed and published the first comprehensive, evidence-based plan for psychiatrists, psychologists and other mental health providers to help their patients quit smoking. His paper appeared in a recent issue of The Canadian Journal of Psychiatry.

"These doctors and mental health specialists focus on their patients' psychiatric health and lose track of their physical health," said Hitsman, who is a health psychologist. "Tobacco cessation gets a lot of attention, but we leave out a population that smokes the majority of all the cigarettes."

Between 40 to 80 percent of people with mental illness are daily smokers, depending on the disorder, compared to less than 20 percent of people who don't have problems with mental illness, according to research. The mentally ill also smoke more cigarettes per day -- often up to two packs. They have a disproportionately high rate of tobacco-related disease and mortality, such as cardiovascular disease or cancer, with a correspondingly heavy financial burden to the health-care system.

The mentally ill receive tobacco treatment on only 12 percent of their visits to a psychiatrist and 38 percent of their visits to a primary care physician, Hitsman said.

Doctors erroneously believe mental disorders will worsen if they take away a person's tobacco. "Not a single study shows that symptoms get worse," Hitsman said. He examined 13 randomized clinical trials that measured psychiatric symptoms during smoking cessation treatment. Seven studies showed that psychiatric symptoms actually improved during smoking cessation treatment, and six showed no changes.

Another problem is mental health professionals believe tobacco is not a real addiction compared to other drug addictions.

"The perception is patients need tobacco because it's their only source of pleasure and helps them feel better," Hitsman said. "There is very little evidence, though, that smoking cigarettes serves to self-medicate emotional symptoms."

There is evidence from a few studies, however, that when mental health providers insert smoking cessation treatment into the mental health treatment plan, they can help their patients quit or cut down.

"They find if you take advantage of the relationship with the counselor and insert smoking cessation counseling into treatment that you enhance quit rates," Hitsman said.

His tobacco cessation plan combines cognitive behavioral therapy, pharmacotherapy and motivational counseling to help the patient quit. Hitsman also has identified several treatment medications that may further facilitate quitting for this population.

People with mental disorders do have a harder time quitting than the general population, Hitsman acknowledged, but said newer studies show it is possible to enhance the chance of success with this approach. Even if patients simply reduce their smoking, they are much more likely to quit successfully at a later date.

To help motivate the patient, the counselor highlights the benefits of quitting, the personal costs of smoking and the barriers to cessation success. "It gets the person in a problem-solving mode, at the basis of which is a solid relationship with the counselor," Hitsman said.

Tobacco dependence also needs to be treated as a chronic disease, Hitsman believes. "We know that treatment provided for a longer duration substantially increases the abstinence rates of people without mental disorders," he noted. "Smokers with mental illness may be especially likely to benefit from extended or maintenance tobacco treatment."

Hitsman's colleagues on the paper are Tony George, M.D., professor and chair of addiction psychiatry at the University of Toronto, Taryn Moss, a psychology student at the University of Toronto and Ivan Montoya, M.D., medical director of the division of pharmacotherapies and medical toxicity at the National Institute on Drug Abuse.


Story Source:

The above story is based on materials provided by Northwestern University. Note: Materials may be edited for content and length.


Cite This Page:

Northwestern University. "Doctors Fear Asking Mentally Ill To Quit Smoking." ScienceDaily. ScienceDaily, 9 September 2009. <www.sciencedaily.com/releases/2009/09/090909111632.htm>.
Northwestern University. (2009, September 9). Doctors Fear Asking Mentally Ill To Quit Smoking. ScienceDaily. Retrieved April 23, 2014 from www.sciencedaily.com/releases/2009/09/090909111632.htm
Northwestern University. "Doctors Fear Asking Mentally Ill To Quit Smoking." ScienceDaily. www.sciencedaily.com/releases/2009/09/090909111632.htm (accessed April 23, 2014).

Share This



More Mind & Brain News

Wednesday, April 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Study Says Most Crime Not Linked To Mental Illness

Study Says Most Crime Not Linked To Mental Illness

Newsy (Apr. 22, 2014) A new study finds most crimes committed by people with mental illness are not caused by symptoms of their illness or disorder. Video provided by Newsy
Powered by NewsLook.com
How Smaller Plates And Cutlery Could Make You Feel Fuller

How Smaller Plates And Cutlery Could Make You Feel Fuller

Newsy (Apr. 22, 2014) NBC's "Today" conducted an experiment to see if changing the size of plates and utensils affects the amount individuals eat. Video provided by Newsy
Powered by NewsLook.com
Do We Get Nicer With Age?

Do We Get Nicer With Age?

Newsy (Apr. 22, 2014) A recent report claims personality can change over time as we age, and usually that means becoming nicer and more emotionally stable. Video provided by Newsy
Powered by NewsLook.com
How to Master Motherhood With the Best Work/Life Balance

How to Master Motherhood With the Best Work/Life Balance

TheStreet (Apr. 22, 2014) In the U.S., there are more than 11 million couples trying to conceive at any given time. From helping celebrity moms like Bethanny Frankel to ordinary soon-to-be-moms, TV personality and parenting expert, Rosie Pope, gives you the inside scoop on mastering motherhood. London-born entrepreneur Pope is the creative force behind Rosie Pope Maternity and MomPrep. She explains why being an entrepreneur offers the best life balance for her and tips for all types of moms. Video provided by TheStreet
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins