Williams, a professor of psychiatry and director of the Division of Addiction Psychiatry at the Robert Wood Johnson School of Medicine, told attendees that the broad public health success that has been achieved with regard to decreasing smoking in the general population has not been extended to those with mental illness—especially serious mental illness. “Smoking is the leading cause of death in people with mental illness or addiction,” she said, citing statistics showing that 50 percent of deaths among people with schizophrenia, bipolar disorder, and depression are attributable to smoking, and that persons with mental illness or addiction purchase and consume up to 44 percent of all cigarettes in the United States.
Moreover, tobacco use disorder is a diagnosable condition in DSM-5. Yet psychiatrists have largely not treated their patients for smoking for a variety of reasons—including a prevalent belief that quitting smoking may actually interfere with treatment of mental illness. But Williams presented evidence showing that smoking cessation has no negative impact on treatment and does not jeopardize recovery from addiction to other substances. And she cited her own 2012 study in the Journal of Clinical Psychiatry demonstrating the safety and efficacy of varenicline in patients with schizophrenia and schizoaffective disorder.
“We as psychiatrists should provide treatment to all smokers,” Williams said. “We should intervene more during periods of temporary abstinence—we detox for other substances; we should detox for this substance. We should promote education and provide leadership to change [smoking] policies at treatment centers. And we should provide national leadership and advocate as physicians.”
For more information, see the Psychiatric News article "Smoking Cessation for Patients Called an Urgent Priority."