Doctors Unable to Restrain Mentally Ill From Smoking

CHICAGO – Depressed and anxious people are among the heaviest smokers, but doctors seldom insist that they quit, fearing their mental disorders will get out of hand. A researcher has, however, questioned this theory.

That is a myth, says Brian Hitsman, tobacco addiction specialist and assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine.

Hitsman has designed and published the first comprehensive, evidence-based plan for psychiatrists, psychologists and others to help their patients quit smoking.

“These doctors and mental health specialists focus on their patients’ psychiatric health and lose track of their physical health,” said Hitsman, who is also a health psychologist.

Between 40 to 80 percent of the mentally ill are daily smokers, depending on the disorder, compared to less than 20 percent of those considered normal, say researchers.

The mentally ill also smoke more cigarettes per day — often up to two packs. They have a disproportionately high rate of tobacco-related disease and mortality, such as cardiovascular disease or cancer, with a correspondingly heavy financial burden to the health-care system.

Doctors erroneously believe mental disorders will worsen if they take away a person’s tobacco.

“Not a single study shows that symptoms get worse,” Hitsman said, according to a Feinberg release.

He examined 13 randomised clinical trials that measured psychiatric symptoms during smoking cessation treatment. Seven studies showed that psychiatric symptoms actually improved during smoking cessation treatment, and six showed no changes.

His paper appeared recently in the Canadian Journal of Psychiatry.

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