Smoking and mental health - NCSCT

More documents

Recommendations

Info

Smoking and mental health Smokers who are highly addicted (%) 25 20 15 10 5 0 All respondents People with a longstanding mental health problem People taking a psychoactive medication People scoring 3+ on the GHQ-12 Fig 2.3 Estimated proportions (with 95% confidence intervals (CIs)) of smokers heavily addicted to cigarettes according to mental health condition and medication use (Health Survey for England (HSE), 2010 4 ). GHQ-12, 12-item General Health Questionnaire. Table 2.6 The proportion of smokers heavily addicted to cigarettes according to mental health diagnosis and medication use (APMS, 2007 9 ) Proportion (%) of smokers heavily addicted on HSI criteria (95% CI) a All smokers 5.32 (4.26–6.64) Reporting a common mental disorder (CIS-R 12+) 10.8 (7.87–14.6) Any disorder 10.4 (7.70–13.8) Depressive episode 14.9 (8.99–23.6) Phobias 14.2 (7.16–26.2) Generalised anxiety disorder 13.4 (8.06–21.4) Obsessive–compulsive disorder 30.4 (16.3–49.4) Panic disorder 3.73 (0.87–14.7) Mixed anxiety and depression 9.54 (5.84–15.2) Post-traumatic stress disorder 7.79 (3.60–16.1) Attention deficit hyperactivity disorder 6.88 (13.2–29.0) Eating disorder 17.0 (6.23–38.7) Probable psychosis 28.5 (8.56–63.0) Currently taking a psychoactive medication b 12.4 (7.88–19.0) a Weighted to account for survey design. b Small numbers make it difficult to assess HSI according to individual drug use with any precision. APMS, Adult Psychiatric Morbidity Survey; CIS-R, revised Clinical Interview Schedule; CI, confidence interval; HSI, Heaviness of Smoking Index. 28 © Royal College of Physicians 2013
Smoking among people with mental disorders 2 the GHQ-12 the proportion was 7%, in those currently taking a psychoactive medication 14%, and in those who also reported a longstanding mental health condition 17% (Fig 2.3). Similar observations apply in APMS data (Table 2.6), which show a particularly high prevalence of heavy addiction among those with obsessive–compulsive disorder and probable psychosis. 2.7 Association between cigarette consumption and mental disorders We examined whether HSE and APMS data support previous reports of an association between dependence on tobacco and severity of mental disorder. 1,3 Table 2.7 shows the proportion of HSE and APMS participants grouped by smoking status and daily cigarette consumption who meet the case definition criteria for the available measures of mental disorder. As can be seen, smokers are much more likely to have a mental disorder than never smokers and, in most cases, ex-smokers. In general, the greater the number of cigarettes smoked per day, the higher the prevalence of mental disorder in that group. Figure 2.4 shows smoking status and daily cigarette consumption in APMS participants grouped by CIS-R score, and also demonstrates a clear dose–response relationship between the severity of mental disorder (indicated by CIS-R score) and smoking behaviour. The higher the CIS-R score the greater the proportion of participants who are smokers, and the higher the average daily cigarette consumption. 2.8 Proportion of cigarettes smoked by people with a mental disorder Previous analysis of APMS data suggested that 42% of all cigarettes consumed in England are smoked by people with a mental disorder. 9 However, this analysis used an inclusive definition of mental disorder, and included people with a dependence on alcohol or illicit drugs, those with problem gambling and those who had made a suicide attempt in the past year. Using the less inclusive definition of mental disorder used throughout this report, 33% of all cigarettes are smoked by people with a mental disorder. The majority of these, 29% of all cigarettes, are smoked by people with a common mental disorder who scored 12+ on the CIS-R. 2.9 Quitting behaviour Although people with mental disorders are more likely to be smokers and more likely to be heavily addicted to cigarettes than those without, data from the HSE © Royal College of Physicians 2013 29
Page 1 and 2: PDF not for circulation Smoking and
Page 3 and 4: Contents Members of the Tobacco Adv
Page 5 and 6: Contents 4.4.3 Attention deficit hy
Page 7 and 8: Contents 6.4.3 Staff knowledge 122
Page 9 and 10: Contents 10.5 Tobacco policy and me
Page 11 and 12: Contributors Anthony Aclet - Specia
Page 13 and 14: Contributors Jill Williams - Associ
Page 15 and 16: 1 Mental disorders 1.1 What is a me
Page 17 and 18: Mental disorders 1 1.3 Common menta
Page 19 and 20: Mental disorders 1 1.4.4 Somatisati
Page 21 and 22: Mental disorders 1 In addition to s
Page 23 and 24: Mental disorders 1 not diagnosed un
Page 25 and 26: Mental disorders 1 Similar to many
Page 27 and 28: Mental disorders 1 12 Chang CK, Hay
Page 29 and 30: Mental disorders 1 52 Young S, Toon
Page 31 and 32: Smoking among people with mental di
Page 41: Smoking among people with mental di
Page 53 and 54: Neurobiological and behavioural mec
Page 77 and 78: Epidemiology of the association bet
Page 93 and 94:
Epidemiology of the association bet
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Smoking cessation interventions for
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
6 Population strategies to prevent
Page 127 and 128:
Population strategies to prevent sm
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Smoking and mental disorders: speci
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
The economic cost of smoking in peo
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Ethical and legal aspects 9 pose co
Page 199 and 200:
Ethical and legal aspects 9 less an
Page 201 and 202:
Ethical and legal aspects 9 patient
Page 203 and 204:
10 Summary and conclusions 10.1 Smo
Page 205 and 206:
Summary and conclusions 10 10.4 Smo
Page 207 and 208:
Summary and conclusions 10 although
Page 209 and 210:
11 Key conclusions and recommendati
Page 211 and 212:
Key conclusions and recommendations
Page 213 and 214:
Page 215:
show all

Smoking and mental health - NCSCT

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?