Researchers say help is needed for patients with mental illness who smoke

April 12, 2017 | 16WNDU

Tobacco use is the single biggest preventable cause of death in the United States, killing 480,000 people every year. Over the past ten years, the number of adults smoking has gone down, but researchers say there is one vulnerable group of people who are not getting the help they need to kick the habit.

Kevin Korotev runs his own graphic animation business. These days he’s got one more success to talk about. After years of smoking, Korotev has quit for good.

“Over the years I’ve gone as high as three packs a day,” Korotev shared.

Korotev‘s health might have been hampering earlier efforts to quit. Korotev has depression.

Li-Shiun Chen, MD, MPH, ScD is a psychiatrist and smoking cessation specialist at Washington University in St. Louis.

She said 57 percent of patients with mental illness are smokers compared to just 15 percent of adults overall.

“We also know that patients with serious mental illness like schizophrenia and bipolar disease die 25 years earlier than the general population,” Dr. Chen detailed.

Dr. Chen said smoking is a big reason. She and her colleagues surveyed 200 patients with mental illness and found 82 percent of the patients who smoked wanted to quit. Fourty-four were willing to take medication but only 13 percent were getting prescriptions from doctors.

Dr. Chen said many providers are so focused on treating the mental illness that other health issues get ignored.

“A lot of people with depression really want to improve their health, pursue healthy lifestyle changes.” Dr. Chen said.

Dr. Chen said smokers with depression can be helped with a combination of counseling and nicotine replacement patches, or one of two drugs.

For Korotev, the prescription drug Chantix helped reduce nicotine cravings, allowing him to stop.

“Like anybody who has recovered from anything, you will always say ‘why did I wait so long?’” Korotev shared.

Dr. Chen said the FDA has recently lifted an earlier black box warning regarding Chantix and depression making it a viable option for patients who also have mental health concerns.

THE SMOKING AND MENTAL HEALTH CONNECTION
REPORT #2414

BACKGROUND: Nearly 1 in 5 Americans suffer from mental health problems such as depression, bipolar disorder, and schizophrenia. Many people go untreated due to various reasons, but that does not mean people everywhere are not suffering silently. Depression is a mood disorder that causes persistent feelings of sadness and lack of interest. There is a long list of symptoms that include irritability, frustration, sleep disturbances, lack of energy, loss of appetite or overeating, anxiety, suicidal thoughts, and the list goes on. Adults often have physical pain and difficulty with memory when depressed. Depression and other mental health disorders can be caused by several sources such as biological imbalances, brain chemistry, hormones, and inherited traits. Stressful events and abuse of alcohol and drugs can make mental health issues worse and because the pain is physiological instead of physical, oftentimes people avoid seeking help because they are ashamed or believe they can manage it on their own. Depression can have dangerous outcomes such as self-harm, and it can also lead to addictions.
(Source: http://www.mayoclinic.org/diseases-conditions/depression/basics/definition/con-20032977)

THE STUDY: Approximately 44% of cigarettes are consumed by people with mental health or substance abuse disorders in the U.S. Individuals with schizophrenia are 3-4 times more likely to smoke compared to the normal population. Cigarettes can cause a number of dangerous health problems such as lung cancer, heart disease, and stroke. More people with mental health disorders smoke cigarettes for some reasons unknown and the chance that they may be self-medicating with nicotine. Smoking is sometimes ignored in patients with mental illness because only their mental problems are being addressed instead of overall physical wellbeing. Cigarettes are used as a relaxation method and might be accepted in therapeutic settings. People with mental illness may not have the same access to aids to help them quit smoking compared to people without mental illness.
(Source: http://www.nami.org/Learn-More/Mental-Health-Public-Policy/Tobacco-and-Smoking)

MEDICATIONS: Chantix is a smoking cessation medicine that can be paired with counseling and behavior modification to help smokers quit. It can cause changes in behavior and recommends to stop taking it immediately if you feel anxious, agitated, hostile, depressed, hyperactive, or have suicidal thoughts. It is also required that you tell your doctor if you have any history of depression or mental illness before starting this medicine. Even nicotine patches can cause sleep disturbances, vivid dreams, and headaches. Nicotine addiction and mental illness go hand in hand and it may be much more difficult for a person with mental health problems to quit smoking, especially if they are facing dangerous side effects from drugs.
(Source: https://www.drugs.com/chantix.html)

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