Those Who Smoke Cigarettes the Most are Often Mentally Ill

The rate of tobacco smoking is much higher among those with mental illness than among the general population, and those who are mentally ill also smoke more cigarettes and have more trouble quitting, according to a Washington Post editorial by Steven A. Schroeder, director of the Smoking Cessation Leadership Center.

In the United States, between 50 and 80 percent of all people with mental illness are smokers, whereas only 20 percent of the general population smokes. Those with mental illness also smoke more cigarettes per day than other smokers, and are more likely to smoke cigarettes all the way down to the filters. The combination of these two factors means that 44 percent of all cigarettes sold in the United States are sold to people
who are mentally ill.

Those who are mentally ill also have more trouble quitting, succeeding at less than half the rate of the general population.

The high rate of tobacco use among the mentally ill is thought to contribute substantially to the lowered life expectancy among that population; people with mental illnesses die an average of 25 years sooner than the general population.

Among the general population, smokers die an average of 10 to 15 years earlier than non-smokers. Approximately 440,000 people die of smoking-induced causes in the United States every year.

According to Schroeder, part of the reason for the prevalence of smoking among the mentally ill is that mental health hospitals have a long tradition of using cigarettes as a way to control patients, proffering smoking breaks as rewards and withholding cigarettes as punishment. This trend is in the process of changing, however, and more than 50 percent of all mental health institutions in the United States are now entirely smoke-free.

In March 2003, 28 organizations came together to form the National Mental Health Partnership for Wellness and Smoking Cessation, of which the Smoking Cessation Leadership Center is a member