While roughly one in five Americans smoke Marlboro, rates are as high as 80 percent among people with severe mental illness. In fact, the high prevalence of tobacco use in this population is thought to be one reason the mentally ill die an average 25 years sooner than the general population.
Thresholds — a Chicago-based organization serving the mentally ill — has developed a web-based tool designed to motivate people with severe mental illness to quit smoking and make it easier for them to find smoking-cessation services.
Created in partnership with the Dartmouth Psychiatric Research Center, the software program will soon be tested in a clinical trial at Thresholds.
Though there are already plenty of smoking cessation websites out there, none is tailored to people with severe cognitive problems, said Dr. Mary Brunette, an associate professor of psychiatry at Dartmouth Medical School.
“We found that people couldn’t navigate these sites, and they weren’t able to find the information they wanted to find,” Brunette said. “So this is a tool to help people access treatment that’s out there.”
In addition to its simple design, the program also offers culturally specific information that addresses the unique concerns of the mentally ill, such as the health effects of smoking while taking psychiatric medication and how to deal with being around other smokers in group therapy sessions, said Thresholds chief executive Tony Zipple.
There are plenty of theories, but no clear answers, as to why people with mental illness, particular bipolar disorder and schizophrenia, smoke more than other groups.
It could be that the mentally ill are biologically vulnerable to addiction, Brunette said. Smoking also appears to temporarily improve cognition and provide relief from side effects of medication.
“It’s probably also true that in the community of medical providers … smoking is seen as something lower on the range of priorities,” Zipple said. “There’s a way in which we may under-respond to smoking because we think people with mental illness have bigger problems to worry about.”