Smoking and Mental Illness

Lasser, Karen E.; Boyd, J. Wesley; Woolhandler, Steffie; Himmelstein, David U.; McCormick, Danny; Bor, David H.

doi:10.1001/jama.284.20.2606

Cited by 2,231 publications

(777 citation statements)

References 33 publications

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“…There may be other variables, such as mental illness, related to smoking and work productivity that were not controlled for in this study. As those with mental illness are both more likely to smoke and exhibit decreased employee productivity,31, 32 quitting smoking may not alleviate the work productivity burden within the mentally ill population. Future research could examine how smoking affects work productivity loss in the mentally ill population.…”

Section: Discussionmentioning

confidence: 99%

Benefits of quitting smoking on work productivity and activity impairment in the United States, the European Union and China

et al. 2017

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SummaryBackgroundSmoking has important health and economic consequences for individuals and society. This study expands the understanding of work‐related burden associated with smoking and benefit of smoking cessation across the US, European Union (EU) and China using large‐scale, representative survey methodology.MethodsData utilised the 2013 National Health and Wellness Survey in United States (US), EU5 (UK, France, Germany, Italy, and Spain) and China. Working‐aged respondents 18‐64 were used in the analyses (US N=58 500; EU5 N=50 417; China N=17 987) and were categorised into: current smokers, trying to quit, former smokers and never smokers. Generalised linear models controlling for demographics and health characteristics examined the relationship of smoking status with work productivity and activity impairment (WPAI‐GH). The WPAI‐GH measures were: absenteeism, presenteeism, overall work impairment, and activity impairment. Separately, current smokers were compared with those who quit 0‐4, 5‐10 and 11 or more years ago on WPAI‐GH end‐points.ResultsCurrent smokers reported greater absenteeism in the US and China and greater presenteeism, overall work impairment, and activity impairment than former and never smokers across the three regions. Those who quit even 0‐4 years ago demonstrated lower absenteeism, presenteeism, and activity impairment in China and lower presenteeism, overall work impairment, and activity impairment in the US and EU5.ConclusionsSmoking was associated with significant work productivity loss in the US, EU5 and China. The results suggest that quitting benefits extend to work productivity rapidly after cessation, serving to further encourage and promote the implementation of workplace cessation programs.

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Section: Discussionmentioning

confidence: 99%

Benefits of quitting smoking on work productivity and activity impairment in the United States, the European Union and China

et al. 2017

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“…Smoking rates stand at above 70% for those with severe mental illnesses such as schizophrenia and bipolar disorder 1, 2, 3, are similarly high among individuals with substance use disorders 4, 5 and are also above average for those with common mental disorders, including depression and anxiety 1. People with mental illness or substance use disorders are more likely to be heavier and more dependent smokers 6, 7, and their life expectancy is reduced by up to 20 years 8, 9, mainly because of smoking 7.…”

Section: Introductionmentioning

confidence: 99%

A mixed-method systematic review and meta-analysis of mental health professionals' attitudes toward smoking and smoking cessation among people with mental illnesses

et al. 2016

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Background and aimsPeople with mental illnesses and substance abuse disorders are important targets for smoking cessation interventions. Mental health professionals (MHPs) are ideally placed to deliver interventions, but their attitudes may prevent this. This systematic review therefore aimed to identify and estimate quantitatively MHPs attitudes towards smoking and main barriers for providing smoking cessation support and to explore these attitudes in‐depth through qualitative synthesis.MethodsThe online databases AMED, EMBASE, Medline, PsychINFO, HMIC and CINAHL were searched in March 2015 using terms relating to three concepts: ‘attitudes’, ‘mental health professionals’ and ‘smoking cessation’. Quantitative or qualitative studies of any type were included. Proportions of MHPs' attitudes towards smoking and smoking cessation were pooled across studies using random effects meta‐analysis. Qualitative findings were evaluated using thematic synthesis.ResultsThirty‐eight studies including 16 369 participants were eligible for inclusion. Pooled proportions revealed that 42.2% [95% confidence interval (CI) = 35.7–48.8] of MHPs reported perceived barriers to smoking cessation interventions, 40.5% (95% CI = 30.4–51.0) negative attitudes towards smoking cessation and 45.0% (95% CI = 31.9–58.4) permissive attitudes towards smoking. The most commonly held beliefs were that patients are not interested in quitting (51.4%, 95% CI = 33.4–69.2) and that quitting smoking is too much for patients to take on (38%, 95% CI = 16.4–62.6). Qualitative findings were consistent with quantitative results, revealing a culture of smoking as ‘the norm’ and a perception of cigarettes as a useful tool for patients and staff.ConclusionsA significant proportion of mental health professionals hold attitudes and misconceptions that may undermine the delivery of smoking cessation interventions; many report a lack of time, training and confidence as main barriers to addressing smoking in their patients.

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“…High‐risk drinkers are substantially more likely to smoke 6, 7, 8, 9, 10 and there is a positive association between the number of cigarettes smoked and alcohol consumption 11, 12. Attempts to quit smoking are less successful among those with alcohol use disorder 13, 14, 15 and episodes of alcohol consumption during a smoking cessation attempt are associated with a greater risk of relapse to smoking 16.…”

Section: Introductionmentioning

confidence: 99%

Association between smoking and alcohol‐related behaviours: a time–series analysis of population trends in England

et al. 2017

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AimsThis paper estimates how far monthly changes in prevalence of cigarette smoking, motivation to quit and attempts to stop smoking have been associated with changes in prevalence of high‐risk drinking, and motivation and attempts to reduce alcohol consumption in England.DesignData were used from the Alcohol and Smoking Toolkit Studies between April 2014 and June 2016. These involve monthly household face‐to‐face surveys of representative samples of ~1700 adults in England.MeasurementsAutoregressive Integrated Moving Average with Exogeneous Input (ARIMAX) modelling was used to assess the association over time between monthly prevalence of (a) smoking and high‐risk drinking; (b) high motivation to quit smoking and high motivation to reduce alcohol consumption; and (c) attempts to quit smoking and attempts to reduce alcohol consumption.FindingsMean smoking prevalence over the study period was 18.6% and high‐risk drinking prevalence was 13.0%. A decrease of 1% of the series mean smoking prevalence was associated with a reduction of 0.185% of the mean prevalence of high‐risk drinking 2 months later [95% confidence interval (CI) = 0.033 to 0.337, P = 0.017]. A statistically significant association was not found between prevalence of high motivation to quit smoking and high motivation to reduce alcohol consumption (β = 0.324, 95% CI = –0.371 to 1.019, P = 0.360) or prevalence of attempts to quit smoking and attempts to reduce alcohol consumption (β = −0.026, 95% CI = –1.348 to 1.296, P = 0.969).ConclusionBetween 2014 and 2016, monthly changes in prevalence of smoking in England were associated positively with prevalence of high‐risk drinking. There was no significant association between motivation to stop and motivation to reduce alcohol consumption, or attempts to quit smoking and attempts to reduce alcohol consumption.

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Smoking and Mental Illness

Abstract: Persons with mental illness are about twice as likely to smoke as other persons but have substantial quit rates. JAMA. 2000;284:2606-2610.

Cited by 2,231 publications

References 33 publications

Benefits of quitting smoking on work productivity and activity impairment in the United States, the European Union and China

Benefits of quitting smoking on work productivity and activity impairment in the United States, the European Union and China

A mixed-method systematic review and meta-analysis of mental health professionals' attitudes toward smoking and smoking cessation among people with mental illnesses

Association between smoking and alcohol‐related behaviours: a time–series analysis of population trends in England

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