Judith J. Prochaska, PhD, MPH. JAMA. 2010;304(22):2534-2535. doi: 10.1001/jama.2010.1759
Individuals with serious mental illness are dying 25 years prematurely, and the major causes of death are tobacco-related cancer, heart disease, and lung disease.1 With a smoking prevalence 2 to 4 times greater than the general population and a greater likelihood of heavy smoking, an estimated 44% of cigarettes sold in the United States are sold to smokers with mental illness or substance use disorders.2
In clinical mental health settings, beliefs prevail that these patients do not want to or cannot quit smoking, or would decompensate if they were to quit smoking.3 More than 40 years after the US surgeon general's first report on the deadly consequences of tobacco use, some mental health sites continue to provide cigarettes to patients for adherence with taking their medications, despite the well-documented evidence that tobacco smoking induces the metabolism of a number of psychiatric medications, resulting in reduced therapeutic blood …
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