People with mental health problems or addictions such as alcoholism or substance abuse tend to smoke more than those in the general population, she said. For example, about 41 percent of the 10 million people in the United States who receive mental health treatment annually are smokers, according to background information in the article.
And, Prochaska added, of the 440,000 people who died each year of smoking-related illnesses in the United States, about 180,000 of them had a mental health or substance abuse problem.
Despite the toll of cigarettes, efforts to help people with mental health and substance abuse issues have been limited because of the mistaken assumption that smoking is a needed coping mechanism and that encouraging people to quit smoking is a lost cause, or will worsen their mental health condition or will make it harder to stay off drugs or alcohol, according to Prochaska.
"It's been in the culture of mental health and substance abuse counseling for so long," she said. "Tobacco has always been there. Treatment providers even smoke with patients; it's that ingrained."
Few researchers have studied smoking cessation and the mental health population, she added. Of about 8,700 trials on smoking cessation, fewer than two dozen have focused on smokers with addictive and mental health disorder because the problems of those patients are seen as too complicated, Prochaska said.
"There has been a longstanding concern that maybe you shouldn't treat tobacco [in patients with mental health problems]," Prochaska said. "But the data coming out now is not supporting that. There is data now that shows smokers with mental concerns are just as ready to quit smoking as smokers in the general population."
In the study, the integrated care was more effective in
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