Duluth News Tribune: Training targets high tobacco use among addicts, mentally ill

By John Lundy

If someone is dealing with other addictions or mental health issues, it’s not the time to ask them to stop smoking.


Wrong, says an addictions psychiatrist from New Jersey who’s in Duluth to help lead a two-day training seminar on helping individuals with special challenges overcome tobacco use.

“The newer research suggests that when people address their smoking they actually have better long-term outcomes,” said Jill Williams, who specializes at Rutgers University’s Robert Wood Johnson Medical School in treatment of tobacco and other addictions in mentally ill populations. “When you cue the brain with nicotine, it’s really not different than other drugs.”

Williams is making her third visit to Duluth at the behest of the American Lung Association in Minnesota. After conducting a one-day session in the Twin Cities, she came to the Public Safety Building in Duluth on Thursday to work with about 60 behavioral health professionals from throughout Northeastern Minnesota; the training continues today.

The target is a topic that has “been shuffled to the side,” in the words of Pat McKone, regional senior director for the American Lung Association.

Even as tobacco use overall in the United States continues to decline to unprecedented lows, use by vulnerable groups such as addicts and the mentally ill remains stubbornly high, McKone and Williams said.

For instance, according to Williams:

  • Although the rate of smoking in Minnesota is down to 14 percent, the rate for Minnesotans with addictions or mental illness is between 40 and 60 percent.
  • The No. 1 cause of death in alcoholics is health problems related to tobacco use.
  • Fifty percent of people with mental illness die of tobacco-related causes.

“We always remark to the audience: Imagine if 50 percent of our patients died of suicide, how that would be front page news,” Williams said. “Fifty percent die from tobacco and we don’t do anything about it.”

People with serious mental illnesses die, on average, 25 years earlier than the rest of the population, McKone said. “And it’s not from suicide; it’s not from drug overdose. It’s from heart disease, COPD and cancer.”

Over a couple of years, Williams has offered the training to about a thousand specialists in Minnesota, she said. But they still represent a minority.

“What we hear them say … is that they’re the lone voice at their agency and everyone else is sort of opposed or still believes the myths or the idea that we should let people smoke and not pay attention to it,” Williams said. “So we still have a lot more people to get to.”

One sign of that is that only one in four mental health treatment centers has a smoking-cessation program, she said.

Families of individuals being treated for addiction or mental illness should advocate for treating their loved one’s tobacco addiction along with the other problems, McKone said. She called the reduced life expectancy for people with addictions and mental illness a social injustice.

Williams added: “Everyone has someone in their family with mental illness or addiction, and we can’t just look the other way.”