University of Kansas Medical Center professor Kim Richter told a roomful of mental health providers last week that they face unique challenges in getting the people they serve to quit smoking.
People with mental illness are 70 percent more likely to use tobacco, she said, and it’s not just the physical addiction to nicotine that makes them want to light up.
“You’re going to have to deal with the fact that they’re in a social system where smoking is the norm,” Richter said, because friends they meet in treatment and family members who share their genetic risk for mental illness are also more likely to smoke.
The Centers for Disease Control and Prevention documented the higher rate of tobacco use among mentally ill Americans in 2012.
Wyandotte County is now teaming with KU Medical Center and a Kansas City, Kan.-based nonprofit called Mental Health America of the Heartland to try to reduce it locally, through a program sponsored by Healthy Communities Wyandotte.
Over four days last week, Richter and Babalola Faseru, her colleague in the Department of Preventive Medicine and Public Health, helped train 19 people who work in area behavioral health programs to be Tobacco Treatment Specialists.
One of them is Chris Leach, a residential manager at an apartment complex in Leavenworth for formerly homeless people with mental health diagnoses.
Leach said he’s seen the pull toward smoking among the mentally ill.
“We think that a lot of it has to do with the fact that they’re using it as a coping skill, and they think it helps them manage stress,” Leach said. “But we also know that people with a mental health diagnosis are living 25 years less on average than a person without a diagnosis.”
Leach said that as a former smoker himself, he’s been able to use his personal story of quitting to help some of his residents. But the training gave him more formal strategies and pointed him toward smoking cessation resources he didn’t know about.
It also gave him a new reason to push his residents to quit: Smoking might counteract their medications.
In addition to all the usual negative health effects of tobacco use, Richter said it can also impede the body’s ability to absorb anti-psychotics used to treat conditions like schizophrenia.
“So they actually have to get dosed higher in order to control their symptoms,” Richter said.
That can pose problems, because the drugs sometimes have severe side effects, she said.
It also means people who are on the anti-psychotics should be monitored closely as they try to quit tobacco, in case their medications need to be adjusted.
Richter said there’s never been more products and support groups — both online and in person — available to help people quit smoking. And Kansas City hosts one that is directly targeted to people with mental illness: a weekly smoking cessation meeting called A Breath of Fresh Air run by SIDE Inc., a mental health peer support center at 630 Minnesota Ave.
“That doesn’t exist in most places,” Richter said.
Kathy Washington, an outreach specialist for SIDE who attended the training, said she quit smoking in 2006 but still remembers the cravings for a cigarette. To help others with mental illness quit, she said she has to “reprogram their cognitive thinking.”
“They say to themselves they need a cigarette, but no, they don’t need a cigarette,” Washington said. “They need to do something else with their hands, or go take a walk. Do something positive with their life instead of negative.”