Attention needed to help combat leading cause of death among those with mental health issues
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It has been 52 years since the Surgeon General first issued a warning regarding the long-term health consequences of tobacco use. Due to great strides in smoking prevention and cessation treatments, the United States as a whole is closer to going smoke free than it has ever been. However, one vulnerable population may require additional policymaker attention and resources if it is to realize a decline in smoking rate: those living with mental or behavioral health issues. 

First, the good news: In the past decade alone, smoking rates in the general population have declined drastically. Today, only 15.1 percent of adults smoke cigarettes compared to 20.9 percent in 2005, according to a 2016 report from the U.S. Centers for Disease Control and Prevention (CDC). Most key disparity groups have seen decreased rates of tobacco use and increased access to cessation resources. Teens, Hispanics, and African Americans have all seen major increases in cessation rates.

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However, people living with mental health issues are one vulnerable group that is not benefitting from this trend. Forty percent of those that suffer from mental problems still smoke and roughly half of all deaths among the mental health population are from tobacco-related illnesses. In addition those with mental health issues are facing a higher risk for addiction, and those with mental health issues who do smoke have a drastically lower rate of cessation.

People with mental health issues who are tobacco users have unique needs and often require more vigorous treatment plans than the average individual attempting to quit smoking. As a certified tobacco treatment specialist and former chairman of the D.C. Tobacco Free Coalition, I am keenly aware of these needs and of how difficult it can be to stop smoking for those living with mental health issues.  

Despite the challenges those living with mental health issues face with smoking, smoking cessation plans and counseling are not part of the majority of mental health programs. In fact, only one quarter of mental health treatment facilities offer any type of smoking cessation services. It is not mandatory for most mental health professionals, including psychiatrists, to be trained in tobacco cessation therapies. Many report that they do not even have access to the necessary resources to help their patients quit smoking.

Changing the reality around tobacco use and mental health behavior will require concrete steps to increase awareness and education among patients, providers, the tobacco control community, and policymakers. Those with mental or behavioral health issues need our support and broad access to smoking cessation treatments, including medication.

Despite smokers with mental health issues being disproportionately affected by tobacco use, they are not yet designated as a disparity group or priority population by the CDC. Designating those with mental health issues as a tobacco disparity group will help smokers with mental health issues access more quit resources and would help spur more targeted training for health care providers about the unique challenges of treating smokers from this particular community.

It is important that all vulnerable populations benefit from the decline of tobacco use and that those living with mental health issues are not forgotten. As Congress and federal regulators consider ways to help people living with mental health issues, they should be sure to address ways to help them quit smoking, which continues to kill a disproportionately high number of those suffering with mental health issues.

Charles Debnam is the Deputy Chief Executive Officer of the Community Wellness Alliance of Washington, D.C. 


The views expressed by authors are their own and not the views of The Hill.