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The facts: mental health and smoking

In Australia, smoking rates for people with mental health conditions range from 25 to 50% depending on their diagnosis. One of the reasons that rates continue to remain high is that there are many myths that persist about the links between smoking and mental health. It’s important to know the facts about smoking, mental health and how to quit, so that you or your patients will have the best chance of quitting for good.

“When I was suffering badly with anxiety, I’d smoke pretty much one after the other” - Anthony

Overall rates of smoking are seeing a decline in Australia, however smoking in mental health populations are still high.

Anthony, who is living with a mental health condition, successfully quit after 30 years of smoking. While the prevalence of smoking is declining in the general community, it remains high among people with mental illness. Compared with the general population, people with mental illness have higher smoking rates, higher levels of nicotine dependence, and a disproportionate health and financial burden from smoking. Approximately 33% of people experiencing mental illness continue to smoke.

Why is it so important to tackle smoking with people with mental health conditions?

  • Smoking is a key contributor to an average reduced life expectancy of up to 10–20 years for people living with mental illness. This is largely due to the increased incidence of lung disease, heart disease and a range of cancers.
  • Smoking is also associated with an increased risk of suicidality.
  • A 2015 systematic review and meta-analysis also found that daily tobacco use is associated with an increased risk of psychosis and an earlier age at onset of psychotic illness. 
  • Smoking interacts with the metabolism of some medications which may necessitate high doses of medications such as antipsychotics for smokers compared to non-smokers.

Take a look at the reasons Thomas Embling Forensic Psychiatric Hospital went smoke free in 2015.

Perceived and actual barriers to quitting

People with mental health conditions can face a number of particular challenges to quitting, which may include:

  • Misperceptions about the safety of stopping smoking on mental health
  • A belief by many that people with mental illness are not able, or not motivated, to quit
  • Generally higher levels of nicotine dependence 
  • Greater contact with other people who smoke
  • Socio-economic factors such as lower income, unstable accommodation and less social supports
  • Lack of supports to quit in mental health settings

For ideas and tips to support your consumer to quit, visit this page.

Suggested Resources

How quitting improves mental health

There are a number of benefits for people with mental health conditions once they have quit.

Find out more

How to embed smoking cessation support into your organisation

Embedding  smoking cessation supports into everyday care for mental health services takes a whole of organisation/service approach.

Find out more

Supporting your patients to quit

Offering evidence-based support and treatment to your patients with mental health conditions will give them the best chance to quit smoking. Most smokers with a mental health condition want to quit, and with the right supports, can quit successfully.

Find out more

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