Smokers with mental health disorders need extra help to quit
By Liz Lockhart
If you have a mental health disorder and you smoke you are five times more likely to succeed in quitting with a little extra help.
Smokers who also have a mental health condition or other substance abuse problem can benefit significantly from smoking-cessation counselling provided by their primary care physicians as this results in five times the success rate compared with those who ‘go it alone’, according to research from the UCLA Jonsson Comprehensive Cancer Centre.
Up to 40% of smokers suffer from these co-occurring conditions, and this group experiences more difficulty when trying to quit. If GPs could offer counselling, it would not only improve their patients’ health but would also cut back on tobacco-related health care costs, said Dr. Michael Ong, an assistant professor of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and a researcher with Jonsson centre.
Ong said that primary care GPs play an important part in smoking-cessation counselling. Prior to this study, however, their effectiveness with this patient population was unclear, Ong added.
‘We found it would be very effective for primary care physicians to provide help in quitting smoking to these patients,’ Ong said. However, in the context of everything these physicians are trying to do in a day, smoking cessation may fall by the wayside.’
‘It’s also been thought that with this patient population, doctors should only take on one thing at a time, for example treating an opiate addiction and opting to deal with the smoking cessation later. But at the end of the day, we showed that smoking cessation counseling is effective in this patient population and should definitely be pursued.’
The research found that the probability of people with co-occurring disorders quitting on their own (without counseling) was 6%. Smokers without these extra disorders had a 10.5% chance of success.
All smokers, both with and without alcohol, drug or mental disorders, are equally likely to receive the opportunity to attend smoking-cessation counseling. However, those with these disorders quit smoking at equal levels when they received help from their doctor.
When smokers with co-morbid conditions receive counseling they have a five times better chance of successfully quitting (31.3%). Smokers without the other conditions have a three times better chance (349%).
‘This study shows that primary care physicians can help smokers with alcohol, drug or mental disorders to successfully quit,’ the study says. ‘These smokers should be targeted for smoking-cessation counselling to reduce the health burden of tobacco.’
During this study Ong noted that there are far higher rates of smoking among people with schizophrenia and those with anxiety and depression disorders.
1,356 participants were studied by researchers in this study to examine the connection between past-year smoking-cessation counselling and successful quitting. The participants had reported smoking in the 1998-99 Community Tracking Study survey and later reported seeing a primary care physician in the last year in a follow-up Healthcare for Communities Survey in 2000-01.
Ong said ‘We sampled for patients with these disorders, and if they were smoking at one time, we followed up two years later to see if they had talked to their primary care physician about quitting and whether they did, in fact, quit smoking.’
‘We picked out smokers from the original survey in 1998 and analysed data from the second survey in 2000. Nobody had ever examined smokers with these co-morbid conditions from this angle before.’
Ong would like the study results to be added to new clinical practice guidelines so that doctors who treat smokers with co-occurring conditions would understand that smoking-cessation counselling in this particular patient population is more successful.
‘Getting people to quit smoking is the number one way to reduce deaths in the U.S. We know these deaths are preventable and we should be incorporating every tool in our toolbox to keep people healthy. This study provides evidence that counselling all types of patients, even those challenging patients with co-morbid conditions, to quit smoking can work.’ Ong concluded.
Source: University of California
