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19 Mar

People with poor mental health die on average 10 to 20 years earlier than the general population, and smoking is the biggest cause of this life expectancy gap.

A joint study by the Royal College of Physicians and Royal College of Psychiatrists found that a third of cigarettes smoked in England are consumed by people with a mental health condition.

While a decrease in smoking rates has also been seen among adults with a long-term mental health condition – falling from 35.3% in 2013/14 to 26.8% in 2018/19 – prevalence remains substantially higher, despite the same levels of motivation to quit.

PHE’s Local Tobacco Control Profiles for England show that as the severity of mental health conditions increases, smoking prevalence is higher.

In 2014/15, prevalence in all adults (aged 18+) was 16.4% and prevalence in adults living with:
Anxiety or depression was 28.0%

A long-term mental health condition was 34.0%
Serious mental illness was 40.5%

Even common mental health conditions, such as anxiety and depression, are associated with a greater likelihood of smoking and of being highly dependent.

Smoking rates are declining in England, with prevalence in adults (aged 18+) having decreased from 17.1% in 2013/14 to 14.5% in 2018/19 (General Practice Patient Survey data).

Addressing higher dependence on tobacco is likely to support smoking cessation, and in turn, reduce health disparities. For people with a mental health condition, smoking cessation improves both physical and mental health and reduces the risk of premature death. Stopping smoking can even be as effective as antidepressants.

The smoking cessation intervention for severe mental illness (SCIMITAR+) trial found that quit support is effective in this population. The incidence of quitting at 6 months shows that cessation can be achieved, but the waning of this effect by 12 months means more effort is needed for sustained quitting.

Smokers reporting depression or anxiety are more likely to be offered stop smoking support by their GPs, but this does not always translate into quitting as higher nicotine dependence is seen amongst this group. When used with stop smoking treatments, e-cigarettes can help people living with a mental health condition to quit.

See the full report here: https://publichealthmatters.blog.gov.uk/2020/02/26/health-matters-smoking-and-mental-health/

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