Research on Behavioral Health and Smoking

Evidence Base for Helping Your Patients Quit Tobacco

• While smoking prevalence nationwide is less than 13%, approximately 20% of American adults with mental health conditions smoke.
• A meta-analysis in the journal Addiction found people with mental illness are motivated to quit smoking. In fact, more than half of people with behavioral-health diagnoses contemplated quitting within the last six months.(Siru et al, Addiction, May 2009)
• More behavioral health patients will die from tobacco use than from their behavioral health issues–and they’ll die from tobacco sooner. It’s time to take action
• JAMA: In this exploratory, serial, cross-sectional study, there were significant reductions in the prevalence of self-reported cigarette smoking among US adults with major depressive episode, substance use disorder, or both, between 2006 and 2019. However, continued efforts are needed to reduce the prevalence further. Read more

• “I challenge all deliveries of care: CSPs, residential, private psychotherapy, and those programs who treat the most vulnerable, who may want to focus on other issues, to think about how they can address tobacco and to adopt a zero-tolerance policy.” ~William Fry, Director, Columbia St. Mary’s Behavioral Health
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• Maintenance Treatment With Varenicline for Smoking Cessation in Patients With Schizophrenia and Bipolar Disorder: A Randomized Clinical Trial (JAMA)
• A Meta-Analysis of 19 Studies Found that Providing Smoking Cessation Interventions During Addictions Treatment was Associated with a 25% Greater Likelihood of Long-Term Abstinence From Alcohol and Illicit Drugs (Journal of Consulting and Clinical Psychology)
• A Meta-Analysis Found that Compared to Those that Did Not Quit, Those that Did Experienced Significant Improvements in Depression and Anxiety and Significant Reductions in Stress (British Medical Journal)

• People with Mental Illness or Substance Use Disorders Die about 5 Years Earlier Than Those Without These Disorders; Many of These Deaths are Caused by Smoking Cigarettes.
  • https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a2.htm?s_cid=mm6205a2_w
  • https://www.cdc.gov/vitalsigns/smokingandmentalillness/index.html
• The Most Common Causes of Death Among People with Mental Illness are Heart Disease, Cancer, and Lung Disease, Which Can All be Caused by Smoking
• Drug Users Who Smoke Cigarettes are Four Times More Likely to Die Prematurely Than Those Who do Not Smoke

Tobacco and Schizophrenia

• Schizophrenia Patients Show Cognitive Improvements After Smoking Cessation
• Smoking Cessation In Patients With Schizophrenia Has Many Long-Term Positive Physiological Effects  (BMC Psychology)
• Tobacco Use Among Individuals with Schizophrenia: What Role has the Tobacco Industry Played? (Schizophrenia Bulletin)
• Nicotine has Mood-altering Effects That Can Temporarily Mask the Negative Symptoms of Mental Illness, Putting People with Mental Illness at Higher Risk for Cigarette Use and Nicotine Addiction.
  • https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a2.htm?s_cid=mm6205a2_w
  • https://www.cdc.gov/vitalsigns/smokingandmentalillness/index.html

• Tobacco Smoke Can Interact with and Inhibit the Effectiveness of Certain Medications Taken by Mental Health and Substance Abuse Patients
• BMJ: A Meta-Analysis Found that Compared to Those that Did Not Quit, Those that Did Experienced Significant Improvements in Depression and Anxiety and Significant Reductions in Stress

Other Research on Tobacco and Behavioral Health

• Comparison of Perceptions and Smoking Cessation Experiences Between Smokers With and Without Serious Mental Illness in a Large Health Maintenance Organization (Journal of Dual Diagnosis)
• Tobacco-Free Policy Outcomes for an Inpatient Substance-Abuse Treatment Center (Health Promotion Practice)
• Smokers with Psychiatric Diagnoses Benefitted More from 16 Weeks of Medication than Those Without Such Diagnoses
• Patients Abstinent from Smoking Experienced Considerable Improvement In Depression
• Efficacy and Tolerability of Pharmacotherapy for Smoking Cessation in Adults with Serious Mental Illness: A Systematic Review and Network Meta-Analysis (Addiction)
• Smoking Cessation and Adults with Serious Mental Illness: The Need for More Research at Every Step of the Quit Process (Nicotine & Tobacco Research)
• Those with Serious Mental Illness Most Likely to Refill Quit-Smoking Medications
• Nearly Half of Substance Abuse Treatment Facilities Offer Counseling or Medication to Help Clients Quit Tobacco Use
• For a Scientific Poster of Research WiNTiP Results, click here.
• Smokers With Behavioral Health Comorbidity Should Be Designated a Tobacco Use Disparity Group
• An Online Survey of Tobacco Use, Intentions to Quit, and Cessation Strategies Among People Living with Bipolar Disorder
• Depression, Smoking, and Heart Disease: How Can Psychiatrists Be Effective?
• Primary Care Providers Advising Smokers to Quit: Comparing Effectiveness Between Those With and Without Alcohol, Drug, or Mental Disorders
• Smoking and Mental Illness — Breaking the Link
• Treating Tobacco Dependence in Clinically Depressed Smokers: Effect of Smoking Cessation on Mental Health Functioning
• Tobacco Use Among Individuals with Schizophrenia: What Role has the Tobacco Industry Played?
• Failure to Treat Tobacco Use in Mental Health and Addiction Treatment Settings: A Form of Harm Reduction?
• Smoking Characteristics of Adults with Selected Lifetime Mental Illnesses: Results from the 2007 National Health Interview Survey
• A Comprehensive Model for Mental Health Tobacco Recovery in New Jersey
• A Comprehensive report: Tobacco Use Among Consumers of Services of the Missouri Department of Mental Health
• Confronting a Neglected Epidemic: Tobacco Cessation for Persons with Mental Illnesses and Substance Abuse Problems
• Addiction: The Scandal of Smoking and Mental Illness
• Common Anxiety Disorders Make it Tougher to Quit Cigs, October 25, 2010
• Treatment of Smokers with Co-Occurring Disorders: Emphasis on Integration in
  Mental Health and Addiction Treatment Settings, Annual Review of Clinical Psychology, Volume 5, 2009