Smoking and Mental Health: A Double Dilemma

Quitting smoking isn’t easy – it takes time and planning. The Great American Smokeout event on the third Thursday in November is a great day to start the journey toward a smoke-free life. Thousands of people who smoke across the country move toward becoming healthier and reducing their risk for all kinds of poor health outcomes by taking steps to quit smoking on this day.

Many current smokers have a mental illness.  In fact, out of 37.4 million US adults who smoke, 14.6 million are diagnosed with a mental illness.  Smoking starts early – studies of youth receiving inpatient treatment for mental health issues found that between 40% and 60% smoked regularly.  People with mental illnesses and substance use disorders also smoke heavily, consuming almost 40% of all cigarettes are smoked by adults.  That is enough cigarettes to make 10 round trips from the earth to the moon!

Some of the reasons that appear to contribute to this link between mental illness and smoking include the way that our brains work.  Nicotine affects brain chemicals, like dopamine, and may cause some people to experience fewer symptoms of mental illness in the short term, seeming to enhance concentration and relaxation.  Unfortunately, over the long-term smoking does the opposite. 

Unfortunately, smoking leads to heart disease and stroke, multiple types of cancer, diabetes, and lung diseases like COPD.  Smokers die an average of 10 years earlier than non-smokers, and people with mental illnesses already face an increased risk of early mortality.  The good news is that the earlier in life a person stops smoking, the more years of life they can gain back.  People who quit smoking before age 35 added 10 years of life making their life expectancy, erasing almost all the risk for premature death.  People older than 35 are also able to add years to their life by quitting, so it is never too late to quit. 

70% of people with mental illnesses who smoke want to quit.  Quitting is hard work.  90% will not successfully quit smoking on their first try.  Less than 10% are successful at quitting cold turkey.  While it will seem tough and may be stressful at first, quitting smoking does not have a long-term negative impact on mental health recovery, and includes so many positive health and financial benefits.  It is important for all people who want to quit smoking to get help.  Supports and aides help people quit for good.

Quitting supports include therapy, which may take place on-on-one or in a group.  Apps and quitlines provide on demand support for individuals who are trying to quit smoking.  They are conveniently accessible by phone, text and/or online devices.  Medications help control withdrawal symptoms and cravings associated with quitting smoking.  Nicotine replacement therapy (NRT) helps people to wean themselves off nicotine while eliminating the act of smoking and the harmful cancer-causing toxins it creates.  Some require a doctor’s prescription and others are available over the counter.  Therapy plus medications or NRT’s is more effective than just therapy or medication or NRT alone. 

For more information, call the national quitline at 1-800-Quite-Now, or visit this site for a list of apps, text programs, and medications that can help, from Mental Health America.

Staff Blogger: Emily Coggin Vera, Executive Director

Emily Coggin Vera is the Executive Director at the Mental Health Association in Delaware, where she has worked since 2009. She was formerly the Deputy Director and the Project Director of Suicide Prevention, during which time she facilitated the Delaware Suicide Prevention Coalition, coordinating suicide prevention efforts by multiple agencies throughout the state. She collaborates with other agencies to provide advocacy and enhanced understanding of mental health in the community, and is responsible for maintaining financial accountability, sustainability and operational effectiveness at MHA. Emily received her Master’s in Social Work from Virginia Commonwealth University in 2007, and is a Licensed Clinical Social Worker.

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