Smoking greatly reduces life expectancy for those with serious mental illness

That is the title of this article I am reviewing today. "'Smokers with serious mental illness have their lives cut short by about 15 years, compared with people who have never smoked and who do not have serious mental illness, research from the University of Michigan shows. They also die 10 years earlier than those with serious mental illness who have never smoked. This means smoking may account for nearly two thirds of the overall difference in life expectancy between individuals with serious mental illness who smoke, and never smokers in the general population, says Jamie Tam, a doctoral candidate in the Department of Health Management and Policy at the U-M School of Public Health, who conducted the study. 'Smoking reduces life expectancy for everyone but we tend to underestimate the importance of smoking for people with comorbidities,' Tam said. 'We know from existing research that people with mental illness live shorter lives, but what wasn't known is how much of that is due to their mental illness and how much is due to the fact that many of them are smokers.' About 42 percent of people with serious psychological distress are smokers, compared with the general population at less than 20 percent.'"  If most smokers are people with mental illness then with these new taxes what are they going to do.  I know when I smoked eighteen years ago I would spend most of my social security check on cigarettes and hardly any food.  I know others will probably do the same.
The article goes on to say: "To find out the contribution of smoking to reduced life expectancy among people with serious psychological distress, Tam and School of Public Health faculty members Kenneth Warner and Rafael Meza analyzed data from 328,000 individuals 25 years and older from the National Health Interview Survey gathered from 1997-2009. They linked it with the 2011 National Death Index. Tam said a disproportionate number of those with serious mental illnesses—including bipolar disorder, schizophrenia and major depression—live in poverty, as they are often unemployed and many face homelessness and social conditions that increase their likelihood of smoking and in turn their risk of other health conditions. Deaths by suicide and accidents also occur more frequently in this population. Among those with serious psychological distress, the researchers found that 47 percent of the deaths are due to the three leading health complications associated with smoking: heart disease, cancer and stroke."  I quit because my daughter told her mom that she would not let my granddaughter who was just born in a house that had smoke.  So I decided my granddaughter was more important than smoking.  I was smoking about one and half packs a day. I had to have at least three cigarettes every morning just to start my day.  I quit with wellabutrin. There were so many side effects that I did not have time to think about smoking and I wanted my granddaughter at my house that when a month had past my doctor gave me a refill although I did not use it because I just did not smoke and did not want the side effects that was eighteen years ago and I do not miss it.
The article ends: "'This highlights the need to prioritize preventive care, including smoking cessation programs, for people with mental illness,' said Meza, senior author of the study and assistant professor of epidemiology at the U-M School of Public Health. Many people with mental illness lack adequate health care—only 32 percent of those with serious psychological distress report seeing a mental health professional—and many don't get their physical health care needs met, Tam said.
'A large majority of people with mental illness don't access mental health care, and even when they do, other health concerns like smoking are not addressed,' she said. 'There have been calls to integrate smoking interventions into mental health care but these recommendations haven't been fully implemented.'"  They really need to have something that does  not have side effects for the people to quit.  I heard it is hard but with medicines you also need willpower or a good reason to quit. I had a reason and I just did not need the headache of the medicine that was supposed to help.

Adults with Schizophrenia at Greater Risk of Premature Death

That is the title of this article I am writing about. "Adults with schizophrenia are 3.5 times more likely to die prematurely, particularly from cardiovascular and respiratory diseases, compared to the average population, according to a new study published online by JAMA Psychiatry.  Many factors contribute to the risk of premature death, including economic disadvantage, negative health behaviors, and difficulty accessing and adhering to medical treatments. Specifically, the following harmful traits are more common in those with schizophrenia than in the general population: smoking, limited physical activity, obesity, elevated blood glucose level, hypertension, and dyslipidemia (abnormal amount of lipids, such as fat or cholesterol, in the blood)."I wonder is it the antipsychotic drugs we take that could cause respiratory diseases. I wonder because I am going through something with my lungs right now.  About a month ago I was diagnosed with walking pneumonia.  Now I have to go see a  lung specialist because it has not left my lungs. I do not smoke and have not smoked in seventeen years.
The article goes on to say: "Among the 65,553 deaths with a known cause, 55,741 were from natural causes, which include a variety of diseases, and 9,812 were due to unnatural deaths, which included suicide, homicide assault, and accidents, both poisoning and non-poisoning, according to the results.
Cardiovascular disease had the highest mortality rate and accounted for almost one-third of all natural deaths. Cancer accounted for about one in six deaths. Among the other natural causes of death, chronic obstructive pulmonary disease (COPD), diabetes, influenza, and pneumonia had the highest mortality rates.  Unnatural causes of death accounted for about one in seven deaths with known causes, with suicide accounting for about one-quarter of the unnatural deaths. Accidents accounted for more than twice as many deaths as suicide."This is disturbing news for me. I do not want to go back on disability.  I hope I have good news tomorrow at the lung doctor.
The article ends with: "Nonsuicidal substance-induced death, mostly from alcohol or other drugs, also was a leading cause of death.  Limitations noted by the authors include not having information about key health risk factors such as smoking status, body mass index, and substance abuse.

“The results from this study confirm a marked excess of deaths in schizophrenia, particularly from cardiovascular and respiratory disease, that is evident in early adulthood and persists into later life,” writes Mark Olfson, M.D., M.P.H., of Columbia University, New York, and coauthors.
'Especially high risks of mortality were observed from diseases for which tobacco use is a key risk factor. These findings support efforts to train mental health care professionals in tobacco use prevention and treatment and in implementation of policies that incentivize smoking control interventions in settings treating patients with schizophrenia.'"That would make me give up smoking if I still smoked this is serious business. Like I have said before I have grand kids I want to see grow up.

Adults with Mental Illness twice as likely to use tobacco

That is the title of this article that I am writing about.  Smoking is a hard thing to quit. “Adults with mental illness are twice as likely to use tobacco as adults without mental illness, according to a new American report.  The report found 37.8 percent of adults with mental illness smoke, compared to 17.3 percent of adults without mental illness.  Nearly one-half of adults in the study who experienced mental illness reported smoking in the last 30 days. Smoking rates are highest among those with serious mental illness, multiple disorders and substance use disorders.  Kansas adults with mental illness are twice as likely to use tobacco as adults without mental illness, according to a new report by RTI international and funded by the Kansas Health Foundation.” I never understood why it has a calming effect for people with mental illness.

When I was in my mental illness I do know that I smoked more I do not know why although I did.   In fact I train smoked cigarettes. “The smoking rate among adults with mental illness remains high despite progress made in tobacco control and the decrease of smoking among the general population.’ Said Betty Brown, research health analyst at RTI and lead author of the study.  ‘As a result, people with mental illness are at an increased risk of negative health, financial, and social outcomes associated with their tobacco use.” I quit sixteen years ago. I was a heavy smoker and probably heard this story.  My granddaughter was about to be born and my daughter who was living with her mother told her mother that she had to quit for the baby.  Instead I wanted to babysit my granddaughter and I quit instead.  I went to my doctor and he prescribed Wellbutrin.  It had so many side effects that in a month I gave up on the Wellbutrin and smoking.
I know others have a hard time quitting.  If it was not for the side effects that kept my mind off of smoking I probably would have COPD or something it was getting that bad at thirty five years old I was coughing and I was not sick. “Our findings emphasize the importance of collaboration between the mental health and tobacco control communities to provide cessation support to individuals with mental illness who use tobacco,’ Brown said. ‘To address the issue of tobacco use among those with mental illness and the challenges associated with making progress toward a solution, the Kansas Health Foundation has launched a new effort to address tobacco use among Kansans with serious mental illness through its Fellows leadership program.” I know it is hard quitting although it can be done.  I know if I would not have had so many side effects from the medication I probably could not have quit.  The money I save and also getting to have my grandkids over whenever I want is worth it.
The article ends with: “Through the years we’ve seem significant decreases in the percentage of Americans who smoke, but we’ve done very little to make strides in decreasing those rates among people with mental illness.’ said Dr. Jeff Willett, vice president for programs at the Kansas Health Foundation.  People with mental illness smoke at nearly double the rate of the general population, we see this collaborative effort being a call to action to both the mental health and tobacco control communities.”  As much as I loved to smoke I never thought I would quit. Although the time came and things had changed and I quit because something was more important and it was costing me plenty to smoke all my money not spent on groceries but cigarettes.  My parents that supported my tobacco use throughout all my years of being locked up could not understand why I did not quit before but the time was not

Alcohol, Tobacco, Drug Use Far Higher in Severely Mentally Ill

That is the title of this article I am writing about. “In the largest ever assessment of substance use among people with severe psychiatric illness, researchers at Washington University School of Medicine in St. Louis and the University of Southern California have found that rates of smoking, drinking and drug use are significantly higher among those who have psychotic disorders than among those in the general population.  The finding is of particular concern because individuals with severe mental illness are more likely to die younger than people without severe psychiatric disorders.  These patients tend to pass away much younger, with estimates ranging from 12 to 25 years earlier than individuals in the general population, said first author Sarah M. Hartz, MD, PhD, assistant professor of psychiatry at Washington University.  They don’t die from drug overdoses or commit suicide -- the kinds of things you might suspect in severe psychiatric illness.  They die from heart disease and cancer, problems caused by chronic alcohol and tobacco use.”  Those two things are a wakeup call to stop using and live a long life.  Twenty three years sober is what I have in April it will be twenty four and I do not miss going to jail never knowing what I did the night before.  Fifteen years not smoking which I do not miss the high prices or the smell.

We all want to live a little bit longer if we can.  “The study analyzed smoking, drinking and drug use in nearly 20,000 people.  That included 9,142 psychiatric patients diagnosed with schizophrenia, bipolar disorder or schizoaffective disorder – an illness characterized by psychotic symptoms such as hallucinations and delusions, and mood disorders such as depression.  The investigators also assessed nicotine use, heavy drinking, heavy marijuana use and recreational drug use in more than 10,000 healthy people with mental illness.  The researchers found that 30 percent of those with severe psychiatric illness engaged in binge drinking, defined as drinking four servings of alcohol at one time.  In comparison, the rate of binge drinking in the general population is 8 percent.  Among those with mental illness, more than 75 percent were regular smokers.  This compares with 33 percent of those in the control group who smoked regularly.   There were similar findings with heavy marijuana use: 50 percent of people with psychotic disorders used marijuana regularly, versus 18 percent in the general population.  Half of those with mental illness also use other illicit drugs, while the rate of recreational drug use in the general population is 12 percent.”  It would be nice to know if they continued doing what they always did or did they just start after their mental illness.

The article goes on to say: “I take care of a lot of patients with severe mental illness, many of whom are sick enough that they are on disability, said Hartz.  And it’s always surprising when I encounter a patient who doesn’t smoke or hasn’t used drugs or had alcohol problems.  Hartz said another striking finding from the study is that once a person develops a psychotic illness, protective factors such as race and gender don’t have their typical influence.  Previous research indicates that Hispanics and Asians tend to have lower rates of substance abuse that European Americans.  The same is true of women, who tend to smoke, drink and use illicit drugs less often than men.  We see protective effects in these subpopulations, Hartz explained.  But once a person has a severe mental illness, that seems to trump everything.  That’s particularly true, she said, with smoking.  During the last few decades, smoking rates have declined in the general population.  People over age 50 are much more likely than younger people to have been regular smokers at some point in their lives.  For example, about 40 percent of those over 50 used to smoke regularly.  Among those under 30, fewer than 20 percent have been regular smokers.  But among the mentally ill, the smoking rate is more than 75 percent, regardless of the patient’s age.  With public health efforts, we’ve effectively cut smoking rates in half in healthy people, but in the severely mentally ill, we haven’t made a dent at all, she said.”  With drinking I believe you have to hit your bottom to quit.  I do not care how many A.A meeting you go to until something happens that is too much for you it will not be successful.  For smoking to quit you have to have a reason other than the cost.  You have to it is not an option to smoke any more.
My major in college was a drug and alcohol counselor.  I went on to go for my Master’s in Public Administration because I could not help a teenager that I believe they were suspending wrongly so I quit and went on to my get my Masters instead.  “Until recently, smoking was permitted in most psychiatric hospitals and mental wards.  Hartz believes that many psychiatrists decided that their sickest patients had enough problems without having to worry about quitting smoking too.  There were also concerns about potential dangers from using nicotine-replacement therapy, while continuing to smoke since smoking is so prevalent among the mentally ill. Recent studies, however, have found those concerns were overblown.  The question, she said, is whether being more aggressive in trying to curb nicotine, alcohol and substance use in patients with severe psychiatric illness can lengthen their lives. Hartz believes health professionals who treat the mentally ill need to do a better job of trying to get them to stop smoking, drinking and using drugs.  Some studies have shown that although we psychiatrists know that smoking, drinking and substance use are major problems among the mentally ill, we often don’t ask our patients about those things, she said.  We can do better, but we also need to develop new strategies because many interventions to reduce smoking, drinking and drug use that have worked in other patient populations don’t seem to be very effective in these psychiatric patients.”  It is probably because they say my life is messed up right now and that is all I have.  I am lucky I have things that I want and a family that I love and want to succeed so that helps me.  Also I know I touch alcohol again and it is back to prison because it will be soon that I do something stupid.

Smoking, Diabetes Linked to Natural Deaths in Schizophrenia Patients

That is the title of this article I am writing this blog about. “Smoking is one of the top natural causes of death in patients with schizophrenia, according to a new study.  Researchers found that schizophrenia patients were 4.7 times more likely to die within the 6.2 years of follow-up if they were smokers.” They do not say how much they smoke.  I used to smoke one and a half packs a day.  I was coughing in the elevator one day and this guy said you smoke and I said yea he said you’re not going to make it to fifty.  That is not the reason I quit.  My ex-wife was supposed to quit because my granddaughter was born and was going to live with her.
I quit because I wanted my granddaughter to be able to come and visit me.  I went to the doctor and he prescribed wellbutrin.  My friend sent me a list of the side effects from this medication and darn if I did not have all the side effects.  My mouth and tongue tasted awful.  After a month of this the doctor gave me another prescription although I did not fill it.  I had already quit and it has been fifteen years.  I was skinny and spent all my money on cigarettes not on food.  “But in half the patients with immune conditions, diabetes was also a leading cause of death.  Nearly one third of patients with schizophrenia also had urinary infections.  These findings underscore the life-shortening effects of smoking in this population and the urgent need to more vigorously promote smoking cessation, said study author Faith Dickerson of the Sheppard Pratt Health System, Baltimore.” I do not want diabetes that is why I walk every day.
I have not lost any more weight because I do the same walking every day.  If I do extra like on Saturday and Sunday I work out on the treadmill.  I would keep gaining.  I also watch what I eat.  I do as I have said before I want to be there when my youngest grandson grows up.  I want to make sure they are ok before I die. “Of 517 participants in the study, six died of unnatural causes and 25 died of natural causes, primarily heart-related conditions.  Other natural causes were respiratory, neoplastic, infectious, blood disease, and mental (delirium, in one patient).” I am going to keep working out even if I get no results.
The article goes on to say: “Problems concerning the immune system were found in 20 percent of patients who died compared to 4.7 percent of those who did not- raising the risk of death to a significant 4.5-fold increase.  The most common immunologic condition was insulin-dependent diabetes, found in 16 to 33 patients with such conditions. Cardiovascular problems were most common in survivors as well as in patients who died, and were tied to a 2.5-fold increased mortality risk. Finally, genitourinary conditions, particularly urinary tract infections, were found in 32 percent of patients who died, compared with 8.6 percent of those who survived – a 4.35-fold increased mortality risk.  It is of note that urinary tract infections have been found to be highly prevalent in persons with acute psychotic symptoms, said the researchers.” Diabetes most of us get it from taking the medication. It is good to take walks or any kind of exercise to not get it. Even if you do not have grandkids it is worth it to enjoy life without a disease.  Why suffer it is not so hard to take a walk when it is getting dark and cool to enjoy the day.

Quitting Smoking and Recovery

This is a follow up to Donald’s blog about smoking and the mentally ill.  Also here is an article about the mentally ill smoke one third of the cigarettes in the United States.  I used to smoke about fourteen years ago that is the age of my oldest granddaughter.  I was not the one that was supposed to quit.  It was supposed to be my ex-wife as my granddaughter was going to live with her.  Although I wanted my granddaughter on weekends and any time I could get her.  I decided to quit.
I had smoked for fifteen years at that time.  I was never out of cigarettes even when in jail.  I would smoke the kind that your roll your own or buy them two for one.  Even when the last time I was in prison I smoked generics.  When I was released from the state hospital my smoking had gone up to a pack and half a day of Marlboros.  That was my favorite cigarette.  When I was on SSI I would spend 120 dollars on five cartons of cigarettes and the rest on TV dinners for food for the month.
I knew how to cook although I did not really start until my granddaughter was old enough to eat and I had quit smoking.  One girl who knew me at college and at my job at that time said “he smokes like a train.”  Whenever college had a break in class you could find me smoking.  I smoked three cigarettes upon waking up in the morning.  When I decided to quit, I went to my doctor and he gave my zyban and wellbutrin to quit smoking.  You cannot combine the two so I used wellbutrin.
First thing I did was call a friend who learned and taught quitting smoking classes.  He sent me a list of the side effects from wellbutrin.  I started the wellbutrin and did not know what to do with all the cigarettes I had so I asked this guy at school he said give them away or throw them away.  I gave them to a friend in my building that was always out.  I received the list of side effects from my friend for the wellbutrin.  Darn if I did not have every side effect listed.  I suffered for a month including to have to brush my tongue a lot during that month because all the nicotine or the medication was coming out and it tasted awful.
When the month was up I went back to the doctor and he refilled the prescription although I did not refill it because of the side effects.  I have not smoke since that time.  I do not know what helped all the side effects or the medicine.  I just know I do not crave them and I could not afford to smoke Marlboros now.  I gained weight because I was hardly eating when I was smoking.  I do know it was self-medicating because I am schizophrenic.  Whenever I was mentally ill I would smoke more. I am happy my daughter wanted to raise my grandchildren in a smoke free environment the most she could.
There is no telling how much I would be smoking if I did not quit.  The thirty days were the hardest not because I craved cigarettes but because of the side effects of the medication.  I would do those thirty days over to quit smoking again though.  Many things were happening around the time I quit so I cannot blame all the weight on quitting smoking.  Although with a change in exercising and portion size I am losing the weight.  I do not want to get back to the low weight of 135lbs I weighed when I smoked though.  I want to weigh a little more.

Schizophrenia and Risk of Heart Attack

This article talks about heart attack and schizophrenia. “Data tell us that people with schizophrenia have lifespan 20 years shorter that the general population.” We have to find out why and change that fact if we can. I know I would love to be around as long as I can to see my grandkids grow up and marry. Just see them find the life that they love. “There are different factors for this including and unhealthy lifestyle (substance abuse, smoking, not enough exercise, poor diet, etc.) increased rates of diabetes and problems brought on by the use of some antipsychotic medications.” These are things we can change to live a longer and better life.
I make sure on weekends that I walk for at least forty five minutes on both days. We cannot change the fact that we take medication. I have cut back on the amount of medications I take with my doctor. I found by exercising and I do not need all that medication. It is small steps that help. They have been tracking this for four years: “…tracking all incidents of heart attack and comparing the results among people with and without schizophrenia.” We must make our hearts better.
What else can be done? “Dr. Kurdyak offers two possible solutions: prevention is one (healthier lifestyle). The other is aftercare (all specialists need to work together to ensure that patients are seen again after a first incident of heart attack). They found that people with schizophrenia were significantly less likely (50 per cent) to receive cardiac procedures or to see a cardiologist within 30 days of discharge from hospital.” Why are they not seen the article does not answer this question. It is always good to see a doctor for follow up.

Self Medicating or Self Destruction

These are some of the facts I have found as a tobacco user requiring mental health services:

Smoking causes a myriad of deathly ailments such as peripheral vascular disease, and hypertension. Smoke contains many carcinogenic products that combine with DNA and cause genetic mutations within the human body. Tobacco also contains nicotine which is a highly addictive psychoactive chemical, the smoke of tobacco, when inhaled causing physical and psychological dependency. This habit may cause also miscarriages and premature births.

Cigarette smokers often speak of cigarettes as relieving stress, though a cigarette smoker’s stress level may be higher than someone who doesn’t smoke, while lessening the amount or quitting the habit of cigarette smoking actually lessens the stress level. Habitual smokers need nicotine to feel normal. Nicotine has a half shelf life in the human bodies system of only 2 hours and withdrawal symptoms can appear after smoking 4 or 5 cigarettes. A smoker with a severe dependency will find that nicotine is removed after 10 – 20 days in the human body though psychological dependence may last months, even years.

A very large group of schizophrenics use tobacco as self medication. Nicotine patches have been thought to be used for a treatment for not only schizophrenia yet also to help them to reduce even quit smoking so that they become healthier, though this is not conclusive for treatment. Smoking linked to anxiety disorders maybe related and not limited to only depression and ongoing research is attempting to explore the addiction-anxiety relationships. There is evidence though that when a smoking treatment program is inserted into a client’s treatment plan, they can (the mental health providers) help their patients to cut down their smoking or even quit. Behavioral therapy and pharmaceuticals have been known to help the mentally ill to cut down smoking, though they have a harder time quitting alone.

By Donald Sammons

smoking

Smoking
· 40% - 60% of people with depression smoke
· 61% of people with bi-polar disorder smoke

People who use tobacco, who don’t quit can or will die of smoking related problems, especially those with a serious mental illness who may die 25 years earlier than the “normal” non-smoker.

We hear a lot about smokers who exist in the mental health category, yet not very much about cigarette use amongst adults who work full time or adolescents. The two categories cannot be readily compared yet it can be stated that in the food and restaurant occupation, cigarette use is nearly 50% in that work force, the highest of most occupations where 33 million full time employees from the age of 18 to 64 do smoke, the lowest being 15% for those in the physical, psychological and social science occupations.

There are many studies of cigarette smoking amongst adolescents from the age of 12 to 17 years of age who may be smoking 1 – 2 packs of cigarettes a day. Studies such as these have taken place over a 27 state range throughout the United States. Cigarette smoking cause more than 400,000 deaths every year and most smokers begin in their adolescence. There are many prevention programs throughout the United States, not only from the private sectors of businesses yet also the government and state level as well. Cigarette use has a major role in the health of many citizens in every state in this nation, and to reduce making and changing the attitudes of smoking in people will have achieved progress in maintaining the health of these people.

People who are clients within the Mental Health system, who have a mental illness, are known to smoke more than all other people in other occupations; twice as much. The reasons for such high smoking statistics in schizophrenics and other serious mental illness are social, psychological and physical; and smoking amongst people with mental illness is viewed as not just smoking, yet self medicating as well.
It is hard to tell the difference between nicotine withdrawal and the symptoms of mental illness, when people are being treated for a possible mental illness, in all this treatment for mental health is a bit more difficult.

These are just a few of the unnoticed attitudes about smoking that have been established in the United States and abroad. So while most everyone I have ever met smokes because of nerves, or a friend got them started, the fact remains that smoking tobacco takes its toll, even amongst the mentally ill.

by Donald Sammons