People with mental illnesses die about 25 years sooner than the general population and experts say smoking could be a major reason.

 

According to new data from the Centers for Disease Control and Prevention, 36 percent of those living with mental illnesses smoke, compared with 21 percent overall. The report says 31 percent of all cigarettes are smoked by adults with mental illness. And 40 percent of men and 34 percent of women with mental illness smoke.

There are many theories on why people with mental illnesses smoke more, says Mark Salzer of Temple University's Department of Rehabilitation Sciences. For instance, smoking alters mood and reduces stress. But Salzer says those smokers tend to be poor and not well educated, other risk factors for smoking.

Mental-health professionals have not done enough to address smoking among their clients, Salzer says. For example, mental-health centers should be smoke-free environments, he suggests, and the topic should come up in treatment.

"Having individual providers, psychiatrists, case managers, therapists asking people about their smoking behavior routinely, and encouraging people to stop smoking, referring people to smoking-cessation programs -- these are all things that easily could be done and are not routinely done," said Salzer.

A New Jersey program called CHOICES offers training and advice on smoking cessation to mental health centers and their clients throughout the state.

Smoking rates high among mental-health providers too

Program director Patricia Dooley says smoking rates are also high among mental-health providers, which is likely contributing to the problem.

Dooley says the message is delivered by "peer counselors," people who have a mental illness, but have been trained as counselors. They travel all over the state to speak at mental-health facilities, and to engage staff and clients in conversations.

"They actually go in and provide a 45-minute educational presentation, and then they invite members of the audience to come up and meet one-on-one with them," explained Dooley.

Dooley says it is often harder for mentally ill people to quit smoking. It can take longer, she says, and it requires medical supervision because of potential effects on psychotropic medications, mood and sleep.