Persons with mental illness account for more than one-third of adult smokers in the United States and despite a decline in tobacco use during the past five decades, there has been no change in the smoking rate for patients with poor mental health. To combat reliance on tobacco in mental health populations, experts agree that mental health services and government-sponsored tobacco control programs must work together to improve education and access to smoking cessation programs.
"Historically, mental health care has operated separately from general medical practices where collaborations exist to strongly encourage smoking cessation in typical patient populations," said Jill M. Williams, MD, professor of psychiatry at Rutgers Robert Wood Johnson Medical School.
The result of this disconnect, according to Dr. Williams, has left smokers with disparities to become the dominant group of smokers in the United States. This includes smokers with mental illness, as well as other addictions and the very poor. "Disparities research indicates we need tailored strategies to effect these remaining populations of smokers," she said.
In a Viewpoint piece published Online First on October 30 in the Journal of the American Medical Association Psychiatry, Williams said partnerships between mental health providers and state or county tobacco control programs benefit patients, providers and programs. For patients, smoking cessation improves their health by reducing the impact of smoking-related illnesses. This, in turn, lowers costs in treating those illnesses.
"The paradox is that we still pay for the heart disease and cancer that these smokers develop so it makes more sense to help them stop smoking," explained Williams, who recently became chair of New Jersey Breathes, a coalition working for a tobacco-free New Jersey. "We must recognize that smoking has not disappeared, but has become a vital issue for New Jersey's most vulnerable citizens, just as it has nationwide. We need the types of prevention and cessation services that existed when New Jersey had a Comprehensive Tobacco Control Program."
New Jersey eliminated its program in 2010 due to budget cuts leaving millions of smokers without options. Williams cites comprehensive state-run tobacco programs in California and Massachusetts, which have resulted in savings in health care in less than five years. New Jersey nets more than 700 million dollars every year in taxes from cigarettes yet doesn't designate any of that money to be used for programs to help smokers.