Reasons for smoking and barriers to cessation among adults with serious mental illness: A qualitative study

Abstract

AimsMost research into reasons for smoking among adults with serious mental illness (SMI) has focused on reasons related to SMI symptoms. The current study reports reasons for smoking and barriers to cessation that are both related and unrelated to SMI symptoms among adults with SMI.MethodsFour focus groups were conducted among current smokers receiving outpatient care for a psychotic disorder in 2017 (N = 24). Participants were asked why they currently smoke and their barriers to quitting smoking.ResultsSmoking as a coping mechanism and to self‐medicate SMI symptoms were reasons for current smoking and barriers to cessation. Avoidance of other unhealthy behaviors, routine, and enjoyment emerged as reasons for smoking and barriers to cessation that were unrelated to mental illness.ConclusionConsideration of factors that are both related and unrelated to SMI symptoms in smoking cessation interventions and brief cessation counseling may improve cessation success in this population.

Determinants of Tobacco Smoking Addiction in Rural Indonesian Communities

“…This research made some findings different from those of the previous studies that the stress level were not significantly related to addiction risk [ 24 , 25 ], since the stress level in rural areas is lower than that in the urban settlements. It was also observed that the urban settlements experienced more distress compared with the rural areas.…”

Variation in characteristics of people with mental disorders across smoking status in the Canadian general population

“…The disproportionally high number of smokers in the group with mental disorders, along with the socioeconomic disparities, indicates that existing smoking cessation programs are not sufficiently able to meet the smoking cessation needs of vulnerable populations. People with mental disorders have many of the same barriers for smoking cessation as people with no mental disorders, such as fear of withdrawal, weight gain, and cessation failure 11,14 . However, evidence also suggests that people with mental disorders face additional challenges [11][12][13][14] .…”

“…Hence, they face more considerable difficulties in quitting smoking. Additionally, people with mental disorders choose to smoke as a self-medication to cope with the effects of mental disorders 11 , a practice that has been positively reinforced due to the widely held belief that smoking benefits mental health. Health professionals may also hesitate to intervene if they believe that stopping smoking is detrimental to their mental health 28 .…”

“…Although most smokers want to quit smoking, many continue smoking as they report that smoking provides them with mental health benefits 9,10 . This issue is even more relevant among people with mental disorders as they experience additional barriers to quit smoking [11][12][13][14] . Evidence shows that smoking cessation can be achieved among people with mental illness using the same intervention (behavioral support and pharmacotherapy) that works for the general population 15,16 .…”

“…The lower rate of smoking cessation among people with mental disorders may be related to their experience of nicotine withdrawal symptoms during the cessation process, fear that cessation could lead to withdrawal symptoms that they may face, and the perceived benefits of smoking on mental health [11][12][13][14] . Furthermore, they may misinterpret the immediate loss of nicotine withdrawal symptoms after smoking as mental health benefits, and do not act to curb or quit smoking.…”