Smoking
rates in the general population have fallen dramatically over the past few
decades. But they have remained stubbornly high among people with mental health
conditions: 70% of those discharged from psychiatric hospitals are smokers. The
result is lives cut short and blighted by years of suffering from heart and
lung diseases, stroke and cancer. These are often called the “stolen years” –
of life, of health and of wealth.
New research
shows particularly high levels of smoking among those in poverty who have a
mental health condition. Around 1 million people with a common mental health
problem are living in poverty and smoking. It is estimated that a further
135,000 would be in poverty if their spending on tobacco were taken
into account.
There
is an urgent need for action to tackle this growing inequality. A third of all tobacco now smoked in England is by
someone with a mental health condition. Yet the desire to quit among these
smokers is just as strong as for the average smoker. They do not lack
motivation to quit, but are likely to be highly addicted and heavily dependent
on tobacco, and therefore need more help. When asked if anyone providing
inpatient care had offered them help to stop smoking, two-thirds
of mental health patients who smoked said no. The first principle of medicine
is do no harm. But harm can be caused not just by a wrong action, but also by a
failure to act. For the goal of “parity of esteem” to be meaningful, people
with mental health conditions need help to quit smoking.
In
Action on Smoking and Health (Ash)’s report, Stolen Years, developed with the Royal
College of Psychiatrists and endorsed by a wide range of mental health and
public health organisations, we call for much more help for these people to
quit smoking. The report challenges defeatist assumptions that addiction to
smoking among people with mental health conditions is either inevitable or
intractable: it is not.
There
is no single magic bullet that will reverse decades of inaction. A social
movement is required across the whole system which challenges professional
complacency, provides training for staff, and access to the right medications
and services for smokers.
But
at the heart of this social movement must be smokers and the people who care
for them. Through listening to their experiences and meeting their needs we can
successfully implement challenging but essential policies such as smoke-free
mental health services.
This
is not a quick fix, nor will it be easy. But without a collective effort we
will continue to condemn millions of the most vulnerable people in our society
to needless disease and premature death.
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