Navigation Links
Doctors fear asking mentally ill to quit smoking
Date:9/9/2009

CHICAGO --- People with mental illnesses such as depression and anxiety are the heaviest smokers in the country, but their doctors are afraid to ask them to quit. They assume that if their patients try to quit smoking, their mental disorders will get worse.

That is a myth, according to Brian Hitsman, a tobacco addiction specialist and assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine. He also is a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

This population's tobacco use and dependence need to be treated, he said. Hitsman has designed and published the first comprehensive, evidence-based plan for psychiatrists, psychologists and other mental health providers to help their patients quit smoking. His paper appeared in a recent issue of the Canadian Journal of Psychiatry.

"These doctors and mental health specialists focus on their patients' psychiatric health and lose track of their physical health," said Hitsman, who is a health psychologist. "Tobacco cessation gets a lot of attention, but we leave out a population that smokes the majority of all the cigarettes."

Between 40 to 80 percent of people with mental illness are daily smokers, depending on the disorder, compared to less than 20 percent of people who don't have problems with mental illness, according to research. 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.

The mentally ill receive tobacco treatment on only 12 percent of their visits to a psychiatrist and 38 percent of their visits to a primary care physician, Hitsman said.

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. He examined 13 randomized 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.

Another problem is mental health professionals believe tobacco is not a real addiction compared to other drug addictions.

"The perception is patients need tobacco because it's their only source of pleasure and helps them feel better," Hitsman said. "There is very little evidence, though, that smoking cigarettes serves to self-medicate emotional symptoms."

There is evidence from a few studies, however, that when mental health providers insert smoking cessation treatment into the mental health treatment plan, they can help their patients quit or cut down.

"They find if you take advantage of the relationship with the counselor and insert smoking cessation counseling into treatment that you enhance quit rates," Hitsman said.

His tobacco cessation plan combines cognitive behavioral therapy, pharmacotherapy and motivational counseling to help the patient quit. Hitsman also has identified several treatment medications that may further facilitate quitting for this population.

People with mental disorders do have a harder time quitting than the general population, Hitsman acknowledged, but said newer studies show it is possible to enhance the chance of success with this approach. Even if patients simply reduce their smoking, they are much more likely to quit successfully at a later date.

To help motivate the patient, the counselor highlights the benefits of quitting, the personal costs of smoking and the barriers to cessation success. "It gets the person in a problem-solving mode, at the basis of which is a solid relationship with the counselor," Hitsman said.

Tobacco dependence also needs to be treated as a chronic disease, Hitsman believes. "We know that treatment provided for a longer duration substantially increases the abstinence rates of people without mental disorders," he noted. "Smokers with mental illness may be especially likely to benefit from extended or maintenance tobacco treatment."


'/>"/>

Contact: Marla Paul
marla-paul@northwestern.edu
312-503-8928
Northwestern University
Source:Eurekalert

Related medicine news :

1. UK junior doctors gaining less experience of common procedures
2. Doctors Often Miss High Blood Pressure in Kids
3. One-fourth of HIV patients believe their doctors stigmatize them
4. Annual flu shot cuts need for doctors visits, hospitalization among children
5. Teens need to see their doctors more often
6. Doctors and medical ethicist discuss whether doctors should participate in capital punishment
7. Doctors and Medical Ethicist Discuss Whether Doctors Should Participate in Capital Punishment
8. South Texas Doctors Report More Severe Cases of Community Staph Super Bug Hospitalizing Children
9. Maimonides Expands Circulation of Physicians Practice Journal to Staten Island Doctors
10. Doctors Debate Drugs vs. Surgery for Angina
11. UCI Medical Affiliates Inc. Opens a New Doctors Care Center in Anderson
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... Yisrayl Hawkins, Pastor and Overseer ... one of the most popular and least understood books in the Holy Scriptures, Revelation. ... descriptions that have baffled scholars for centuries. Many have tossed it off as mere ...
(Date:10/12/2017)... ... 2017 , ... First Healthcare Compliance (FHC), an industry leader ... range of technology and learning solutions at the 68th Annual American Healthcare Association ... held October 14–18, 2017 at the Mandalay Bay Resort in Las Vegas, Nevada. ...
(Date:10/12/2017)... ... October 12, 2017 , ... The American College of Medical Informatics ... PhD, FACMI, during the Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s ... of Morris F. Collen, a pioneer in the field of medical informatics, this prestigious ...
(Date:10/12/2017)... ... October 12, 2017 , ... Leading pediatric oncology experts at Children’s National ... 49th Congress of the International Society of Paediatric Oncology (SIOP) Oct. 12-15. ... for Cancer and Blood Disorders at Children’s National, and Stephen P. Hunger, M.D., ...
(Date:10/12/2017)... ... 2017 , ... Vohra Chief Medical Officer Dr. Shark Bird, ... nursing facility medical directors and other clinicians at various events in October. His ... many of these conferences we get to educate other physicians, facility nurses, corporate ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... , Oct. 2, 2017 Halo Labs announces the European ... system called the HORIZON at MIBio 2017 in Cambridge, ... and visible particulate matter in biopharmaceutical samples with unprecedented speed and ... the novel technique Backgrounded Membrane Imaging. ... The HORIZON subvisible particle analysis system ...
(Date:9/28/2017)... -- Cohen Veterans Bioscience and Early Signal Foundation announce ... home sensors for real-time monitoring of patients with trauma-related ... organization focused on disruptive health solutions for rare disorders ... to record and integrate behavioral, cognitive, physiological and contextual ... ...
(Date:9/25/2017)... Sept. 25, 2017   Montrium , an ... solutions, today—from the IQPC Trial Master Files & ... NL)—announced that EastHORN Clinical Services has selected ... and TMF management. EastHORN, a leading European contract ... to increase transparency to enable greater collaboration with ...
Breaking Medicine Technology: