Doctors Wrongly Assume Harm in Asking Mentally Ill Smokers to Quit

Smoking is widely prevalent among individuals with mental illnesses, but many doctors are loathe to encourage such patients to quit out of a misguided fear that doing so will exacerbate their mental problems, Science Daily reported Sept. 9.

“These doctors and mental-health specialists focus on their patients’ psychiatric health and lose track of their physical health,” said Northwestern University assistant professor and health psychologist Brian Hitsman, who recently published a guide for doctors who want to help mental-health patients quit smoking. “Tobacco cessation gets a lot of attention, but we leave out a population that smokes the majority of all the cigarettes.”

An estimated 40 to 80 percent of people with mental illnesses are daily smokers. However, mental-health patients get treatment for smoking on just 12 percent of visits to psychiatrists and 38 percent of visits to primary-care physicians, according to Hitsman.

Contrary to popular belief, no research has shown that psychiatric symptoms get worse when smokers quit; in fact, said Hitsman, some studies have shown that psychiatric patients actually improve during smoking-cessation treatment.

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

Hitsman’s smoking-cessation plan appears in the June 2009 issue of the Canadian Journal of Psychiatry.