Though we do need to be cognizant of the fact that in some cases (perhaps many cases) smoking is self medication for various psychological problems- just as drinking can be. In cases where it is self medication, the problem is greater than a simple substance addiction problem:
Cigarette Smoking and Mental Illness
NEW YORK CITYVOICES: November/December 2001
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By Janine Budah, CSW, Community Relations Representative, The Holliswood Hospital
Cigarette smoking has a strong connection to those with mental illness, according to a review of the medical and public health literature by the National Alliance for the Mentally Ill (NAMI) policy staff. The findings are backed by existing science and research and indicate that chronic schizophrenia patients smoke at a rate that approaches 90%. Patients coming to a medical center for treatment for a variety of psychiatric conditions including depression are more likely to be smokers than the general population.
Perhaps some explanation for this lies in the fact that nicotine is psychoactive and has demonstrated effects on alertness and memory. Nicotine is known to affect the receptors for many brain neurotransmitters and to promote the release of dopamine, serotonin, acetylcholine, and norepinephrine — all of which are thought to be related to serious brain disorders such as schizophrenia. However, nicotine has also been shown to decrease the blood level of antipsychotic medications by increasing the excretion by the kidneys, therefore causing smokers to require higher doses of antipsychotic medications than non-smokers.
Behaviorally, there is mounting evidence that smoking is a form of self-medication, since it appears to reduce anxiety and sedation and improve concentration in some people. That being said, in no way do I intend to imply that smoking tobacco is in any way beneficial or justified. The serious health consequences that result are well publicized and documented. The question then becomes “What is being done to address the special needs of the mentally ill to gain insight, awareness and to help motivate them to stop smoking?”
I was very excited to learn of just such a new and innovative program, called QUIT SMART. Laura Fogelman, RNC is the Director of the unique program offered at Flushing Medical Center in Queens. The Center is located at 45th Ave and Parsons Blvd., and Dr. Robert Shipley originally developed the program at Duke University. Both the addictive and psychological aspects of smoking are addressed. Exercises and tools are used that have proven to be very effective in helping to quit the habit.
Laura Fogelman is a registered nurse and certified instructor with expertise in treatment of the mentally ill. She is an integral member of the Outpatient Mental Health Clinic at the facility and sees patients for individual psychotherapy, group psychotherapy and educational training. She views treatment from a holistic point of view. She says, “If you don’t address other health concerns of the mentally ill consumer, you cannot expect to see improvement or progress. For example, if someone has weight gain due to their psychotropic medication, or if their cholesterol is high, these concerns need to be addressed. By the same token, those with mental illness may have a harder time with smoking cessation than the general population and we need to be sensitive to those issues.”
Laura says that although the program is open to the entire community, a large percentage of participants do have a diagnosis of a mental illness. The program consists of four classes over a five-week period and costs as little as $25. In her soft-spoken and encouraging way, Laura stresses that participants should not give up if they are not successful the first time. She explains that if someone has to repeat the program, a “built-in strength is fostered each time.” She says it’s like “renewing a prescription — the medicine doesn’t necessarily cure you the first time you take it… Sometimes a renewal is required.”
If your New Year’s Resolution includes a smoking cessation program or if you want more information, Call Laura at (718) 670-5476.
also see:
no-smoking.org
lorenbennett.org
intelihealth.com,*%7C |
