Marlboro man included...??
Study: Mentally Ill
Smoke More
Targeted Treatment for Psychologically
Vulnerable Needed
The study found that 41 percent of all
mentally ill people smoked cigarettes,
compared to 22.5 percent of people
who had never been mentally ill.
(ArtToday)
By Ephrat Livni
N E W Y O R K, Nov. 21 — People with mental illnesses
are twice as likely to smoke cigarettes as other
people and consume nearly half of all cigarettes
smoked in the United States, a new study says.
The Harvard University and Smith College research,
published in the latest issue of the Journal of the American
Medical Association, suggests a need to target smoking
prevention strategies for the mentally ill, an especially
vulnerable population.
The study found that 41 percent of all mentally ill people
smoked cigarettes, compared to 22.5 percent of people who
had never been mentally ill. Patients with more severe
mental illnesses, such as schizophrenia and depression, had
the highest likelihood of smoking heavily, says study author
Dr. Karen Lasser of the Harvard School of Public Health in
Cambridge, Mass. Lasser is a postdoctoral student in the
school of public health and a physician.
The findings are based on data from 4,411 respondents
aged 15 to 54 years old in an 1991 and 1992 congressionally
mandated survey of psychiatric illness. The information in
the survey has the latest available data about mental illness
and smoking.
Lasser says the results confirm what health-care workers
observe daily in psychiatric facilities — that many of the
patients smoke. She says she hopes such quantifiable data
on the number of mentally ill Americans who smoke will help
public health policy makers to target smoking cessation
programs and funds for the mentally ill.
Tobacco Part of Psychiatric Culture
Experts say mentally ill people smoke so much because
tobacco has become part of the culture of mental health
facilities.
“Institutions, especially state-run, have used tobacco as a
reward [for mentally ill patients],” explains Dr. John
Bachman, a clinical psychologist and nicotine dependency
researcher in Menlo Park, Calif. “Management has said it
won’t be responsible for depriving them of the few pleasures
they have left.”
Smoking rates among the mentally ill are higher because
there is not much social and cultural stimulation in their lives,
he adds, asking, “What does lung cancer in 20 years mean
to a hallucinating patient now?”
Bachman says nicotine has a dual effect — both soothing
and stimulating, depending on what state of body or mind
the smoker is in. Psychiatric patients tend to be on
medications that can dull them, so they often use cigarettes
to stimulate themselves out of a drug-induced stupor, he
says.
Nicotine Replacement Therapy
Although the mentally ill may be a difficult population to
wean off cigarettes, new treatments, such as nicotine
patches, are now available to help them.
Using nicotine patches or gum, so that patients continue
to get the stimulation they seek without the health risks of
smoking, may be especially effective in helping mentally ill
smokers quit, says Dr. Jack Henningfield, an associate
professor of psychiatry at John Hopkins University Medical
School in Baltimore, Md., and contributor to several U.S.
Surgeon General reports on tobacco cessation.
“A decade or two ago we didn’t have anything to offer
[the mentally ill], but now we are on safer footing,” he says.
But since cigarette smoke makes the body metabolize
medication more quickly, smoking cessation for the mentally
ill must be monitored by a health professional so drug doses
are adjusted accordingly, adds Hennigfield. Smoking
cessation programs for the mentally ill should include both
medication and therapy, he says.
The study found that 37 percent of mentally ill smokers
successfully managed to kick the habit, as compared to 42.5
percent for people with no history of mental illness,
suggesting that targeted smoking cessation programs could
be effective.
Lasser says raising cigarette taxes could serves as a
smoking deterrent for the mentally ill because they tend to
have a lower income level. Tax revenues could then be used
to fund smoking cessation and other programs for mental
illness and to support counter advertising campaigns.
Big Tobacco Targets Vulnerable
There have been no studies that have examined the effect of
cigarette advertisements on the mentally ill. But Lasser says
the tobacco industry targets psychologically vulnerable
people as part of their market. In her study, she cited
internal marketing documents from the R.J. Reynolds
Tobacco Company, in Winston-Salem, North Carolina,
describing smokers who smoke for “mood enhancement”
and “positive stimulation.”
“The marketing study implied that smokers used nicotine
for depressive symptoms, stating that smoking ‘helps perk
you up’ and ‘helps you think out problems,’” the study
reports.
R.J. Reynolds spokeswoman Carole Crossler declined to
comment, saying the company had not had an opportunity to
review the study. Spokespeople for Phillip Morris,
headquartered in New York City, also declined to comment.
Sensation-Seeking Smokers
Nov. 21 — People who thrive on the burst of adrenaline that comes from a
roller coaster ride or skydiving may be more likely to smoke than those
who seek solitude and calm, suggests another smoking study.
According to the report in the November issue of Experimental and
Clinical Psychopharmacology, these people — known as sensation seekers
— experience more intense feelings from nicotine than those without this
personality trait.
‘‘Sensation seeking may be related to risk of becoming a smoker
because these people experience greater positive as well as adverse effects
from nicotine,” says Dr. Kenneth A. Perkins, the study’s lead author. “This
leads them to try smoking again and again.’’
Perkins says that over time, these people become tolerant to the
adverse effects of nicotine and may be able to tolerate higher doses.
Study results might help to develop programs that target teens who
smoke, the researchers suggest.
Perkins, from the University of Pittsburgh School of Medicine in
Pennsylvania, and colleagues determined sensation-seeking elements of
personality through a questionnaire. The investigators measured
physiological responses to nicotine, such as heart rate and blood pressure,
after individuals used a nasal nicotine spray at varying doses on three
occasions.
The study participants, including 37 nonsmokers and 55 smokers aged
21 to 40 years.
—Reuters |
