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High Rate of Smokers among Patients with Mental Disorders

Cigarette smoking and other forms of nicotine addiction seem to be more common in patients with mental disorders than in other people. For example, in the US less than 18% of the adult population smoke but up to three quarters of those with schizophrenia are reported to smoke. Moreover, smoking can trigger certain mental disorders, such as dysthymia or major depression, in those who are predisposed to them. Mental health conditions that are strongly associated with smoking include:

  • Schizophrenia
  • Anxiety disorders, such as generalized anxiety disorder
  • Mood disorders including depression, bipolar disorder and dysthymia
  • Attention-deficit hyperactivity disorder (ADHD)

Smoking happens to be also common among people who are dependent on other addictive substances, such as alcohol, suggesting that there may be an association between these addictions.

Nicotine is a powerful stimulant drug known to promote the release of certain neurotransmitters in the brain that affect mood. These neurotransmitters, including dopamine, serotonin and norepinephrine, are related to mental health and their levels are linked to a number of emotional disorders. Some of these disorders, especially mood disorders, may develop in patients at risk for the condition when they quit smoking.

Individuals suffering from a mental disorder often use cigarette smoking as a means of self-medication. Nicotine has a variety of effects on the mind and the body, some of which may seem beneficial in the short run. For instance, nicotine may reduce anxiety, increase a person’s energy level and help enhance sensory perception and improve concentration in some individuals.

Although the medical consequences of smoking are well documented today, research on the relationship between smoking and mental health conditions continues. Unsurprisingly, smoking happens to be among the most preventable causes of death worldwide. Smokers have an increased risk of developing peptic ulcers, lung, throat, oral, bladder and kidney cancers and heart and lung diseases. Secondhand smoke, which often affects non-smokers like children, is almost as dangerous as smoking itself. In addition, nicotine can affect the metabolism of some medications, reducing their effectiveness. This may require the patient to take higher doses of a drug.

Pregnant women who smoke increase their risk of miscarriage and their babies are more likely to have a low birth weight and suffer from behavioral disorders and sustained cognitive deficits (e.g. learning disorders). Smoking during pregnancy may also be associated with an increased risk of certain birth defects, such as abnormal fingers and toes. Many patients with mental health conditions do not recognize the actual hazards of smoking or consider their nicotine addiction to be a trivial matter when compared to their mental disorder.

Nicotine is a highly addictive recreational drug, characterized by immediate withdrawal symptoms. Cigarettes cause the most rapid onset of nicotine effects of all the nicotine products available. This results in their heavier use and makes smoking cessation more difficult. Besides that, when smokers attempt to quit the habit, their withdrawal symptoms are typically more severe if they smoked cigarettes when compared with other tobacco products.

Patients who quit smoking generally experience withdrawal symptoms which begin within a few hours of the patient’s last cigarette, becoming most intense after the first day. Withdrawal symptoms tend to improve after 3 to 4 weeks. Symptoms of nicotine withdrawal typically include cravings, increased appetite and resulting weight gain, irritability, depressed mood, frustration or anger, insomnia, anxiety and coughing.

Quitting cigarette smoking is a difficult task for almost everyone, but it is particularly hard for people with mental health disorders. When patients with emotional disorders try to stop smoking, they often face a temporary worsening of their symptoms. However, this aggravation of their mental health condition can usually be prevented by appropriate adjustments of their medications. The odds that a patient will be able to quit smoking for good improve significantly when their mental disorder is identified and properly treated.

Where to Find More Information: American Psychological Association