The mentally ill are overlooked, dismissed, and stigmatized by society. Public stigma is so intense that many people suffering from mental health issues hesitate to get the help they need. Mentally ill people have harder times holding down jobs and managing adult responsibility. An astounding number of of these folks end up in prison, psych wards, or on the streets. They also happen to be much more likely to smoke. This contributes to the fact that they are expected to live one to three decades shorter than people without mental illness.
A mind-blowing percentage of mentally ill people smoke cigarettes. While 17.8% of the US population smokes, 41% of mentally ill people smoke. According to the Substance Abuse and Mental Health Services Administration, mentally ill people smoke one-third of all cigarettes. According to the National Alliance on Mental Illness (NAMI), these mental illnesses have the following rates for smoking cigarettes: Panic Disorder: 56% PTSD: 60% Depression: 60% Bipolar Disorder: 70% Schizophrenia: 90% You might do a double-take reading these statistics. Rates these high cannot be a coincidence. It begs the question: what makes the mentally ill so prone to cigarette addiction?
THE CHEMICAL ASPECT:
Compulsive behavior for rewarding stimuli, despite adverse effects, is known as addiction. Emotional stress is a common trigger for compulsive behavior. In the case of mental illness, emotional stress is often working overtime. For example, somebody with Generalized Anxiety Disorder (GAD) can be in a constant state of anxiety, without any negative stimuli; their fight-or-flight reaction is constantly misfiring. Somebody with this level of anxiety is much more likely to give in to compulsion. New research suggests that cigarettes have antidepressant qualities. Among the thousands of chemicals found in a combusted cigarette, monoamine oxidase inhibitors (MAOI) have been detected. Monoamine oxidase is involved in removing the neurotransmitters norepinephrine, serotonin, and dopamine from the brain. MAOI’s stop the monoamine oxidase from extracting these neurotransmitters. For these reasons, MAOI’s were used as one of the first antidepressants in the early days of psychiatric medication as we know it. Since then, MAOI’s are only used as a last resort, because of their debilitating side-effects and withdrawal symptoms. MAOI side effects include: nausea, diarrhea, headache, drowsiness, insomnia, skin reactions, dizziness, muscle spasms, inorgasmia, stunted sex drive, weight gain, muscle aches, and increased suicide risk. MAOI withdrawal symptoms include: agitation, irritability, pressured speech, insomnia, nightmares, hallucinations, disorientation, paranoia, aggressiveness, catatonia, and electric shock feelings. In essence, when you try to quit smoking, not only are you withdrawing from nicotine alone. Along with the additives, tar, and carcinogens, you are withdrawing from a dangerous, outdated antidepressant. You can imagine that quitting smoking could be nearly impossible if you suffer from anxiety or depression, as withdrawal from antidepressants alone is agony. Though bipolar disorder and schizophrenia are not fully understood, research suggests dopamine, norepinephrine, and serotonin are crucially involved in psychotic, catatonic, and mood disorder symptoms. Since cigarettes alter the levels of these neurotransmitters, the high rates of smoking in bipolar and schizophrenic patients is understandable.
SMOKING IN PSYCH WARDS:
Psych wards offer an interesting glimpse into the world of smoking and mental health. Families and psychiatric staff passionately defend a psychiatric patient’s right to smoke, for the alleviation of symptoms. Dr. Dale Archer of The Institute for Neuropsychiatry states, “I was and remain amazed at the fervent arguments that doctors (and other mental health care workers) would give in favor of smoking for psych patients. These professionals – not the patients – were the ones that fought the hardest to allow smoking.” Whatever the reason, cigarettes alleviate psychotic symptoms in schizophrenics and manic bipolar patients. This has lead to an unfortunate and widespread practice in the psychiatric world: incentivizing cigarettes. To control a struggling psychiatric patient, medical professionals will often use cigarettes for both positive and negative reinforcement. If a patient is non-compliant, you can take away their smoke break. If they are cooperating, you can give them extra cigarettes. Imagine the stress of losing your mind, being locked up, dosed with mind-altering substances, and the one solace of cigarettes being taken away. Absolutely hellish. Smoking has been proven to shorten lives. Cigarettes are administered by medical professionals. Something is seriously wrong when doctors and medical staff are poisoning their patients. There must be a better way.
A NEW HOPE:
In light of the accelerated death associated with mental illness (a huge percentage related to smoking-related illness), vaping should really be researched and considered for psychiatric purposes. Since nicotine alleviates psychotic and depressive symptoms, why not offer a smoking alternative to patients? Of course, research is of the utmost importance. This is not a policy that can be implemented overnight. But when you consider the fact that vaping has a minute fraction of the chemicals of a cigarette and that more and more public health organizations are coming out in favor of replacing cigarettes with vaping, it could be an incredibly promising alternative. In my view, vaping should be tested on depressives, PTSD sufferers, bipolar patients, and schizophrenics. If patients experience the same symptom relief from vaping as they do from smoking, the mentally ill just might live longer, healthier, happier lives.