By Corinne M. Graffunder, DrPH, MPH (Director of the Office on Smoking and Health, Centers for Disease Control and Prevention)
Rebecca, a former smoker featured in CDC’s Tips From Former Smokers campaign, started smoking cigarettes at age 16. Everyone in her family smoked, and once she started smoking, she quickly became addicted. She kept smoking into adulthood. While she tried to stop, she had difficulty quitting. “I probably tried to quit smoking at least half a dozen times, but the addiction was so strong.”
Rebecca was also diagnosed with depression at age 33, and she is not alone. Smoking is more common among people with mental health conditions than among people in the general population. In fact, people with mental health conditions smoke about 4 out of every 10 cigarettes smoked by adults in the United States.
Rebecca recalls the shame she felt when she tried to quit smoking and couldn’t. “All this time, I didn’t even realize that smoking and my depression went hand in hand. I was smoking to try to help my depression, but it only made things worse.” Struggling to quit made her feel even more depressed.
Smoking didn’t just affect Rebecca’s mental health. She also had gum disease and started losing her teeth. The additional toll smoking had on her health motivated her more than ever before to lead a healthy lifestyle. “I finally realized I had to look to myself for my own happiness and health. I had to quit,” she said. She finally quit smoking and received treatment for her depression.
Today Rebecca feels better than ever, both mentally and physically. “Today, I take care of myself. I eat right. I went back into therapy to self-check and to have a professional to talk to about the trials and tribulations that I go through as a single grandmother, and as someone who wants to stay healthy.”
After she quit smoking, Rebecca began running while taking her grandson along for a ride in his stroller. This activity helped her manage stress and depression and to stay smokefree. Six months after starting to run, Rebecca ran her first 5K. “I actually placed third in my age group. That gave me the confidence to keep going,” she said. Learn more about Rebecca’s story, and the wake-up call that helped her quit smoking for good.
Smoking and Adults with Mental Health Conditions
The percentage of adults with mental health conditions who smoke is at least twice that of the general population, compared with fewer than one in five (17%) adults in the general population.
Smoking-related diseases such as heart disease, lung disease, and cancer are among the most common causes of death among adults. Smoking is not a treatment for depression or anxiety.
Quitting smoking is not easy, but it is possible! Like other smokers, adults with mental health conditions who smoke want to quit, can quit, and can benefit from using proven stop-smoking treatments. By including cessation as part of your treatment plan, you can improve more than just your patients’ physical health – you can improve their overall mental and emotional well-being.
Resources to Help Smokers Quit for Good
Primary care and mental health care providers should routinely screen patients for tobacco use and offer evidence-based smoking cessation treatments. You can help by asking patients about their tobacco use and providing support and education about cessation to those who smoke.
Mental health care professionals and primary care providers can:
Ask their patients if they use tobacco; if they do, help them quit.
Offer proven quitting treatments, including tailored quit assistance, to patients who use tobacco.
Refer patients interested in quitting to 1-800-QUIT-NOW, Smokefree.gov, or other resources.
Provide counseling, support, and stop-smoking medicines, as appropriate.
Make quitting tobacco part of an overall approach to treatment and wellness.
Monitor and adjust mental health medicines as needed in people trying to quit using tobacco.
Free resources to support smokers in their quit journey are at CDC.gov/quit. These tools can help smokers:
Choose a quit date. A new month as a start date is a great idea.
Let loved ones know about their quit journey, so they can be supportive.
List the reasons for quit smoking.
Find out what triggers cause them to smoke, especially during the early days.
Have places to turn to for help right away.
Just like Rebecca, smokers can end the cycle of nicotine addiction. If you are a mental health professional who works with patients who smoke, please take a look at CDC’s Resources for Mental Health Care Professionals.
No matter what your specialty is, you know the damaging effects that smoking can have on your patients’ health. Most smokers want to quit. Getting started often takes support and motivation from trusted sources, like you. With CDC’s Resources for Health Care Professionals, you can help your patients quit smoking for good and begin a healthy, smokefree life.
For more information, check out APA’s Smoking and Health Disparities resource page.
Centers for Disease Control and Prevention. (2013). Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years with Mental Illness—United States, 2009–2011. Morbidity and Mortality Weekly Report 2013;62 (05):81–7 [accessed 2016 July 28].
Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2013). The NSDUH Report: Adults With Mental Illness or Substance Use Disorder Account for 40 Percent of All Cigarettes Smoked [PDF–563 KB]. March 20, 2013. Rockville, MD [accessed 2016 May 18 ].
Dr. Corinne Graffunder is Director of the Office on Smoking and Health within the National Center for Chronic Disease Prevention and Health Promotion. She is responsible for providing broad leadership and direction for all scientific, policy, and programmatic issues related to tobacco control and prevention.
Prior to her current position she served as the Deputy Associate Director for Policy in CDC’s Office of the Director, working to strengthen collaboration between public health, health care, and other sectors to advance CDC’s population health priorities. She has more than 25 years of experience with national, state, and local prevention efforts and working with the US Surgeon General and National Prevention Council, led the development of the first ever National Prevention Strategy: America’s Plan for Better Health and Wellness.
Since joining CDC in 1987, she has held leadership positions in the National Center for Chronic Disease Prevention and Health Promotion and in the National Center for Injury Prevention and Control, working on a range of health issues including tobacco control, cancer prevention and control, and violence prevention. She received her doctorate from the University of North Carolina and her Masters of Public Health and Bachelors of Science from the University of South Carolina.