Myths about quitting smoking harm Kansans with mental illness

Kansans in the mental health community are coming together to preserve our state’s mental health safety net in the face of a $30 million budget shortfall.

Many Kansans — more than 126,000 — live with a serious mental illness. As policymakers, advocates and providers work to maintain core services and contain costs, it is important to consider a strategy for those with mental illness to live longer, healthier lives: helping them quit smoking.

According to the Centers for Disease Control and Prevention, smoking rates across the country have sharply declined over the last 10 years. Currently only 15.1 percent of adults in the United States smoke cigarettes. When last measured in 2013, 18 percent of Kansas adults smoked, which was then on par with the national average.

However, smoking rates among people living with mental illness have not declined. Right now, almost one-third of Americans with mental illness smoke cigarettes.

Tobacco use exacts a terrible toll on this community, with tobacco-related illness the cause of half of all deaths for people with mental illness. In fact, people living with serious mental illnesses die 25 years younger than the general population, likely because of tobacco-related illnesses.

Most smokers with mental illness want to stop smoking but struggle to overcome barriers to access cessation support and treatment.

Although the majority of this community meets the criteria for “tobacco dependence,” making cessation counseling and medications critical, many do not have adequate insurance coverage or access to care. Among those who have health coverage, most don’t know what quit-smoking treatments are covered, and often their providers don’t either.

In addition, coverage can be a patchwork, and providers are not always armed with evidence-based tools and resources necessary to create effective quit plans for their patients. Finally — and this is a big reason — both providers and patients have misconceptions about the risks and benefits of quit smoking medications.

They’re reluctant to try them, and even (falsely) believe that some medications are dangerous for individuals with mental illness. As a result of providers being unsure about the best tobacco cessation treatment for mental health patients, few proactively help their patients quit.

We must take concrete action to overcome these barriers and erase the disparity in tobacco-related disease and death. First, the Food and Drug Administration should prioritize people with mental illness as a tobacco disparity group in order to increase funding for research and resources on this issue at the federal, state and local level.

Second, despite budgetary issues, we must continue to fund programs like a new initiative by the Kansas Health Foundation. Projects funded by this initiative will raise awareness about the benefits of integrating tobacco prevention and cessation treatment into routine behavioral health care and will dispel myths about harms from cessation medications.

Finally, we must inform all health care providers, from primary through behavioral health care, about the prevalence and consequences of smoking among people with mental illness. Providers need to know there are safe, approved, and effective treatments available to help clients quit smoking.

Tobacco use is still the No. 1 preventable cause of death in the U.S., and we are all affected by it. For me, that effect is personal — my mother and father died from COPD and congestive heart failure caused by tobacco.

Tobacco-related deaths are hitting as hard as ever the most vulnerable among us — people coping with mental illnesses. Ensuring these individuals get the best care possible and that providers have the programs and resources they need to provide effective care will go a long way toward reducing the death and disability caused by tobacco.

This story was originally published October 30, 2016 at 6:00 PM with the headline "Myths about quitting smoking harm Kansans with mental illness."