Mental illness, tobacco turn out to be deadly combo

By: John Lundy, Duluth News Tribune
It’s hard to quit smoking.
For individuals struggling with a mental illness, it’s even harder.
“They have higher levels of biological or physical addiction to nicotine, in many cases,” said Dr. Jill Williams, an addiction psychiatrist. “In illnesses like depression, studies show that they’re more addicted than other smokers.”
Yet mental health treatment is lagging when it comes to tobacco addiction, said Williams, who specializes in mental health and tobacco at the Robert Wood Johnson Medical School in New Jersey.
Her effort to correct brings Williams to Duluth today. At the behest of the American Lung Association in Minnesota, Williams is conducting a daylong conference for mental health professionals at the University of Minnesota Duluth.
About 75 people were signed up for the event, said Pat McKone of the lung association. Earlier this week, Williams led a similar conference in Moorhead, Minn., with 100 in attendance.
The Minnesota group brought Williams to the state because of the toll smoking takes on people with mental illness, an American Lung Association news release said. It cites studies from several states showing that people with severe mental illness die, on average, 25 years earlier than the general public. Their No. 1 cause of death? Heart disease related to tobacco use, the studies show.
Moreover, the percentage of people with mental illness who smoke is much higher than that of the general population, the Centers for Disease Control and Prevention reported earlier this year. From 2009-11, 36 percent of adults with mental illness smoked, compared with 21 percent of the rest of the population, the CDC said.
The numbers in Wisconsin are similar, but the discrepancy in Minnesota is even greater: Just over 40 percent of Minnesota adults with mental illnesses smoke, compared to just under 20 percent of the rest of the population.
Part of the problem, Williams said in a telephone interview, is the lack of treatment.
“If you get your care from the behavioral health system, it’s just unlikely that you’ll be able to get treatment for your tobacco addiction in those settings,” she said. “Traditionally, that’s not been offered there.”
People with mental illness respond to medication and counseling to treat tobacco addiction, Williams said, although it may need to be more intense. And the mental health treatment centers and residences already have the counselors trained in addiction treatment, she said. They just need the specific training for tobacco.
“That’s why these trainings are so important,” Williams said. “When we do the training, it’s not unusual that people say this is the first time they ever had training on tobacco addiction in their professional career.”
Another issue, Williams said, is addressing public policy so that people who provide tobacco treatment are reimbursed as well as people who treat other forms of addiction.
“If we paid people better to do tobacco treatment, I think a lot more of it would be available,” she said.