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Smoking Among Adults with Mental Illness

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The latest Vital Signs shows cigarette smoking is a serious problem among adults with mental illness. More needs to be done to help adults with mental illness quit smoking and make mental health facilities tobacco-free.

Janice has suffered from mental illness for most of her life. She had depressive disorders starting in adolescence, and was admitted to a mental health facility for a time when her symptoms became severe. While there, she began smoking because many other patients were doing it, and she wanted to fit in. She noticed that the staff didn't seem to mind patients smoking, and sometimes even used cigarettes to reward good behavior. By taking medication for depression and carefully following her treatment plan, Janice has been able to live a more productive life. She graduated from college and now is able to maintain a job. But she hasn't been able to give up smoking, despite repeated attempts.

The character Janice is not drawn from any one person, but is a blend of the experiences of many smokers with mental illness. Despite overall declines in cigarette smoking in the United States, more people with mental illness smoke than people without mental illness. And just like many others who smoke, many people with mental illness will get sick, become disabled, or die early from smoking-related diseases.

The latest Vital Signs from CDC notes that many adults with mental illness who smoke want to quit, can quit, and will benefit from proven stop-smoking treatments. It's true that some people with mental illness face issues that can make it more challenging to quit, such as low income, stressful living conditions, and lack of access to health insurance and health care. All of these factors make it more challenging to quit. But that doesn't mean that smokers with mental illness can't benefit from the same proven treatments as anyone else.

Smoking Prevalence is Much Higher Among People with a Mental Illness

Nationally, nearly 1 in 5 adults (or 45.7 million adults) have some form of mental illness, and 36% of these people smoke cigarettes. In comparison, 21% of adults without mental illness smoke cigarettes. (Mental illness is defined here as diagnosable mental, behavioral, or emotional conditions and does not include developmental and substance use disorders.)

There are other troubling statistics from the report:

•31% of all cigarettes are smoked by adults with mental illness.

•40% of men and 34% of women with mental illness smoke.

•48% of people with mental illness who live below the poverty level smoke, compared with 33% of those with mental illness who live above the poverty level.

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