Healthcast: Smoking and Mental Health


Tobacco use is the single biggest preventable cause of death in the United States, killing 480,000 people every year. Over the past ten years, the number of adults smoking has gone down, but researchers say there is one vulnerable group of people who are not getting the help they need to kick the habit.

Kevin Korotev runs his own graphic animation business. These days he’s got one more success to talk about. After years of smoking, Korotev has quit for good.

“Over the years I’ve gone as high as three packs a day,” Korotev shared.

Korotev‘s health might have been hampering earlier efforts to quit. Korotev has depression.

Li-Shiun Chen, MD, MPH, ScD is a psychiatrist and smoking cessation specialist at Washington University in St. Louis.

She said 57 percent of patients with mental illness are smokers compared to just 15 percent of adults overall.

“We also know that patients with serious mental illness like schizophrenia and bipolar disease die 25 years earlier than the general population,” Dr. Chen detailed.

Dr. Chen said smoking is a big reason. She and her colleagues surveyed 200 patients with mental illness and found 82 percent of the patients who smoked wanted to quit. Fourty-four were willing to take medication but only 13 percent were getting prescriptions from doctors.

Dr. Chen said many providers are so focused on treating the mental illness that other health issues get ignored.

“A lot of people with depression really want to improve their health, pursue healthy lifestyle changes.” Dr. Chen said.

Dr. Chen said smokers with depression can be helped with a combination of counseling and nicotine replacement patches, or one of two drugs.

For Korotev, the prescription drug Chantix helped reduce nicotine cravings, allowing him to stop.

“Like anybody who has recovered from anything, you will always say ‘why did I wait so long?’” Korotev shared.

Dr. Chen said the FDA has recently lifted an earlier black box warning regarding Chantix and depression making it a viable option for patients who also have mental health concerns.

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