Mental health clinics go tobacco free
People with mental illness are 70% more likely to smoke cigarettes than people without mental illness, according to the Centers for Disease Control and Prevention. Yet smoking cessation programs seldom are offered to mentally ill people as part of their overall treatment plan.
To bridge this gap in caring for a particularly vulnerable population, MD Anderson has joined with Rice University, the University of Houston and Austin Travis County Integral Care — Travis County’s provider of psychiatric and behavioral health services — to eliminate smoking in state-funded community mental health clinics throughout Texas.
This anti-tobacco initiative, known as the Taking Texas Tobacco Free project, is training clinic administrators to implement tobacco-free policies on their campuses and to deliver tobacco cessation interventions to their patients and staff. The initiative is greatly needed, says its director, Cho Lam, Ph.D., assistant professor of Health Disparities Research at MD Anderson and senior faculty fellow in Rice University’s psychology department.
“Adults with mental illness smoke about a third of all the cigarettes in the United States,” Lam says. “They’re at greater risk of dying from smoke-related illnesses than from their mental health conditions.”
The American Psychological Association lists a number of possible reasons why smoking is prevalent in people with schizophrenia, bipolar disorder, depression and other mental illnesses. One of the most probable is that nicotine can improve attention and concentration — appealing benefits for some mental health patients. However, nicotine’s benefits only last about five minutes at a time, leading the person with mental illness to smoke even more.
When patients with mental illness decide to quit smoking, their psychiatrists or mental health professionals must be made aware of their plans to quit, says Lorraine Reitzel, Ph.D., associate professor of educational psychology at the University of Houston and co-director of Taking Texas Tobacco Free.
“Smoking can lessen the levels of psychiatric medications in the bloodstream,” says Reitzel. “But when a patient quits smoking, the medication levels in the patient’s blood can rise and may even become toxic. Medication levels must be closely monitored and adjusted during the process of quitting smoking.”
In the past year, Taking Texas Tobacco Free has been introduced in 117 clinics. The future plan is to introduce the program in an additional 138 clinics.
Funded by the Cancer Prevention and Research Institute of Texas, it’s modeled after Austin Travis County Integral Care’s Tobacco-Free Workplace Program.