AFFIRM

Doctors failing to help smokers with a mental illness quit

New research has revealed many smokers with a serious mental illness are keen to kick the habit, but aren’t given adequate support by doctors.

As many as 60 per cent of people with conditions such as schizophrenia and clinical depression smoke, compared to around 13 per cent of the general population.

“Patients with serious mental illness die an average of 25 years younger than people who don’t have these problems, and smoking is a big factor,” says Dr Li-Shuin Chen from Washington University School of Medicine. “Smoking is a common and serious problem for our patients, and although smoking rates have been decreasing in the general population, the rates remain very high in this vulnerable population.”

Dr Chen’s research team interviewed more than 200 patients with psychiatric illnesses at four clinics in the American city of St. Louis. Of those who smoked, 82 per cent were interested in quitting with many willing to take medication to assist.

Despite that, only 13 per cent were receiving such treatment.

That could be because of a lack of awareness by health professionals. An anonymous survey of psychiatrists found that 91 per cent were under the impression that their patients had no interest in quitting.

Study co-author Dr Laura Jean Bierut says that disconnect needs addressing.

“Research has shown that smoking cessation is beneficial to the mental health of psychiatric patients. When they stop smoking, it decreases the risk of recurrent depressive episodes that can lead to hospitalisation. It also decreases the amount of medication they need,” she says.

The clinics involved in the American study now ask patients to fill out surveys about smoking every time they come in for appointments. Those questionnaires are then given to their doctors before the appointments begin.

“We want the providers to be aware of patient-reported treatment needs and smoking behaviours,” says Dr Chen. “We want the psychiatrists and case workers to know whether their patients have expressed a wish to stop smoking so that they can refer them to counselling or provide them with prescriptions for nicotine lozenges, patches or other medications that may help these patients quit smoking. We think those fairly simple changes really could pay off in a big way.”