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On a macro scale, tobacco use has been on a steady decline within the United States for decades. Yet, for those with mental health or substance abuse issues, smoking has remained quite high. A large portion of the U.S. adult population (25%) have behavioral health issues which directly contributes to 40 percent of all cigarettes smoked in the U.S.

The Relationship

The reason why behavioral health and smoking are so closely related is that smoking a cigarette, or using tobacco in general, can temporarily relieve stress. Nicotine has mood-altering effects that can temporarily mask the negative symptoms of mental illness. However, stopping smoking can overall improve an individual’s depression or anxiety. Tobacco smoke can even interact with and inhibit the effectiveness of certain medications taken by mental health and substance abuse patients. For those in treatment for substance abuse, smoking cessation can increase long-term abstinence from alcohol and other drugs.
Some research has shown that tobacco smokers with behavioral health conditions want to quit, have the ability to quit, and would also benefit from smoking cessation treatments. The most common causes of death for those with mental illness are heart disease, cancer, and lung disease, which can all be caused by smoking.

Quitting the Addition & Changing the Behavior

Those with mental illness are less likely to stop smoking than those living without a mental disorder. As well, there are external and environmental factors that play into why those with mental illness have problems with quitting. Those living with a mental health diagnosis are more likely to have stressful living conditions, low annual income, and possible restricted access to health care to help them quit. All these factors could make it harder for an individual with a mental health diagnosis to quit smoking.

Policy Strategy

Not only is there a personal responsibility for smoking cessation but also public policy is beginning to influence smoking. There are a number of policy strategies put in place to help encourage smoking cessation from a public perspective. In 2006, the U.S. Surgeon General concluded that “workplace smoking restrictions lead to less smoking among covered workers.”

Resources for those with both mental health issues and a smoking addiction need to be readily available. Whether it is from a medical facility or from a public policy, smoking is still an issue for those living with behavioral and mental health challenges.