People who have a serious mental illness, such as schizophrenia or bipolar disorder, and those who have a common mental disorder, such as depression or anxiety, are at greater risk of a range of medical conditions compared to the general population. They experience physical illnesses more frequently and in some cases more severely; and they also have a considerably shorter life expectancy compared to those without a mental illness. The reasons for this are multifaceted; however it is the high rates of smoking in this population that exacerbate these health inequalities. For people with mental illness who smoke, stopping smoking will have the greatest impact on their health.
Whilst primary care settings play a central role in assessing and managing the physical health of people with serious and common mental disorders, mental health inpatient and community staff have a critical window of opportunity to identify people who smoke, advise on the most effective way of stopping smoking and either provide, or refer people for, specialist support.
The Tobacco Free Ireland Programme are currently conducting a secondary analysis of existing Irish health data sets (Healthy Ireland, Health Behaviour of School Age Children and TILDA) to examine the smoking prevalence data cross referenced against other variables such as those indicating that they have mental health conditions. This report is due to be published mid 2018 and will be the first report if its kind for Ireland. In the UK 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. People with substance use disorders, with or without a co-morbid mental health problem, have the highest rates of smoking. In every area of mental health, even child and adolescent mental health services, perinatal psychiatry and older adults care, smoking rates are disproportionally high.
People with a mental illness tend to smoke more heavily and be more dependent on nicotine than those without a mental illness. They are just as likely to want to stop smoking but often lack confidence in their ability to quit and historically have not routinely been offered specialist support to quit.
Smoking Cessation and Mental Health - A Briefing for Frontline Staff.
This briefing document is a tailored resource produced for Mental Health Services in recognition of the unique challenges arising from established practices and misconceptions around mental health and smoking. It is a valuable reference for staff in these services to support and guide them in their day to day interactions with clients and service users. This resource challenges myths and emphasises the crucial role staff play in reducing tobacco prevalence. This resource works alongside The Tobacco Free Campus Toolkit Guidance document, a comprehensive suite of generic tools and resources to support smooth implementation of the policy.