Should Mentally Ill Patients Be Allowed to Smoke?



People with serious mental illness die about 25-30 years earlier than average people, mainly due to diseases caused or aggravated by tobacco. The percentage of smokers amongst such patients can reach 80 %. Experts state that such patients can stop smoking effectively and safely.

Quitting smoking is hard enough on its own, but studies show the challenge is even greater if you suffer from a mental illness — which is why many treatment facilities still allow patients to smoke, even encouraging the habit by using cigarettes as a reward for complying with tests or therapies.

Researchers at the Harvard School of Public Health have discovered that Americans with mental illness are nearly twice as likely to smoke cigarettes as people with no mental illness.

People with mental illness are 70% more likely to smoke than those who are not mentally ill— and at least 50% less likely to quit successfully. This includes people with depression and anxiety disorders as well as those with schizophrenia and bipolar disorder. The more disabling the mental illness is, the higher the smoking rates are, with about 88% of people with schizophrenia being regular smokers.

American adults with mental illness smoke a lot more than adults without any mental illness, with a smoking rate close to 70 percent higher.

The lenient smoking policies are taking a toll, however, and the article notes that a recent report from the National Association of State Mental Health Program Directors showed patients in these facilities are dying on average 25 years sooner than the general population, many from smoking-related diseases. That trend is prompting administrators to re-evaluate their smoking policies, with many hospitals trying to ban or at least rein in smoking.

Why do persons with mental disorders smoke more than others? This study does not really explain. We do know that nicotine is a stimulant, and that it seems to ease the symptoms of some severe disorders such as schizophrenia. 65-90% of persons with schizophrenia are nicotine dependent, probably partly because nicotine relieves some of their symptoms and improves cognitive functioning. Tobacco marketers have played on these statistics, but they probably didn’t create them.


The Working Group on Tobacco and Mental Health at the Catalonian Hospitals’ Smokeless Network was created with support from the Department of Health of the Regional Government of Catalonia in order to progress towards controlling smoking in healthcare centers.

As Montse Ballbè states “the reason for creating this working group was that many practitioners, psychiatrists, psychologists and nurses both from within and outside the network were not doing everything possible to eliminate tobacco from mental healthcare centers”.

The fruit of this working group was the Guide to clinical intervention for eliminating tobacco consumption in mentally-ill patients, which contains the principles and recommendations for proper control of smoking in such centres and covers aspects such as control in indoor spaces, intervention in consumption habits and training of professionals. This Guide was coordinated by Montse Ballbè and Antoni Gual, with contributions from a number of experts, one of them being Eugeni Bruguera.


The kindly smoking policies are holding a toll, however, and a essay records that a new news from a National Association of State Mental Health Program Directors showed patients in these comforts are failing on normal 25 years earlier than a ubiquitous population, many from smoking-related diseases. That trend is call administrators to re-evaluate their smoking policies, with many hospitals perplexing to anathema or during slightest rein in smoking.

Supporting patients with smoking-cessation therapies, however, has had churned results. Patches and resin can assistance in some cases by providing a healing advantage of nicotine with distant reduction risk. And a tiny rough study in Italy suggests that e-cigarettes, that broach nicotine yet a concomitant connect and fume of tobacco, can cut cigarette expenditure by 50% in about half of people with schizophrenia, even if they weren’t perplexing to quit.

The study found that smoking rates for people with mental illness were generally higher in states where overall smoking rates were high. Utah had the lowest rate of smoking among people with mental illness — 18.1 percent — while West Virginia had the highest rate, at 48.7 percent. Smoking among people with mental illness was higher among the poor and less educated, and among American Indians and Alaska Natives, although every ethnic group had significant percentages of smokers.

The study noted several possible reasons that smoking among the mentally ill has been and remains high, including marketing by the tobacco industry and the historical use of cigarettes as an incentive to improve behavior in psychiatric hospitals.