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Continued from page 46 BEHAVIORAL HEALTH AS PART OF THE SOLUTION Behavioral health clinics are a natural setting in which to offer healthy alternatives to tobacco use. While few behavioral health providers currently ask patients about smoking or advise them to quit (Himelhoch & Daumit, 2003), mental health consumers are just as motivated to quit as the general population. Treatment works for these individuals (Addington et al., 1998; Baker et al., 2006; Lasser et al., 2000), and there are simple means for assisting consumers reach their recovery goals. The Smoking Cessation for Person with Mental Illness- Toolkit for Mental Health Providers (Morris et al., 2009) is a resource for a broad continuum of mental health providers, including direct mental health and substance abuse providers and administrators. The toolkit contains a variety of information and stepby-step instruction regarding means of assessing readiness to quit, possible treatments, strategies for reducing relapse, and national resources. Providers are given pragmatic steps that take less than ﬁve minutes, which will effectively assist many mental health consumers quit. The toolkit also offers guidance for those sites, such as integrated health clinics, able to offer additional cessation services. Rather than developing stand-alone cessation services, individual or group tobacco cessation treatment is easily built into existing wellness initiatives. Tobacco cessation is an essential part of healthy living along with stress relief strategies, relationship building, nutrition, regular rest, and exercise. With some additional training, clinicians can deliver effective health messages, provide psychosocial or behavioral interventions like cognitive behavioral therapy (CBT), and refer to appropriate tobacco cessation medications. Mental health consumers need to quit, want to quit, and can quit tobacco use. Tobacco cessation is a key component of many individuals’ recovery, and behavioral health and primary care providers are ideally positioned to help. Stopping tobacco use does not negatively affect either mental health or substance abuse treatment, and may actually enhance other treatments. Chad Morris, PhD, is an Associate Professor at the University of Colorado Denver, Department of Psychiatry, and Director of the Behavioral Health & Wellness Program. Dr. Morris is the principal investigator of multiple studies exploring the effectiveness of psychosocial and pharmacologic tobacco cessation strategies for both youth and adults. He is Past-President of the Colorado Psychological Association, and a licensed psychologist. REFERENCES Addington, J., el-Guebaly, N., Campbell, W., Hodgins, D. C., & Addington, D. (1998). Smoking cessation treatment for patients with schizophrenia. American Journal of Psychiatry, 155(7), 974-976. Baker, A., Richmond, R., Haile, M., Lewin, T., Carr, V., Taylor, R., et al. (2006). A Randomized controlled trial of a smoking cessation intervention among people with a psychotic disorder. American Journal of Psychiatry, 163(11), 1934- 1942. Brown, S., Inskip, H., & Barraclough, B. (2000). Causes of the excess mortality of schizophrenia. British Journal of Psychiatry, 177, 212-217. Colton, C. W., & Manderscheid, R. W. (2006). Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease, 3(2), A42. Dalack, G. W., & Glassman, A. H. (1992). A clinical approach to help psychiatric patients with smoking cessation. Psychiatric Quarterly, 63(1), 27-39. Desai, H. D., Seabolt, J., & Jann, M. W. (2001). Smoking in patients receiving psychotropic medications: a pharmacokinetic perspective. CNS Drugs, 15(6), 469-494. Evins, A. E., Cather, C., Deckersbach, T. et al. (2005). A doubleblind placebo-controlled trial of bupropion sustained-release for smoking cessation in schizophrenia. Journal of Clinical Psychopharmacology, 25(3), 218-225. Forchuk, C., Norman, R., Malla, A., Martin, M. L., McLean, T., Cheng, S., et al. (2002). Schizophrenia and the motivation for smoking. Perspectives of Psychiatric Care, 38(2), 41-49. George, T. P., Vessicchio, J. C., Termine, A. et al. (2002). A placebo-controlled study of bupropion for smoking cessation in schizophrenia. Biological Psychiatry, 52(1), 53-61. Goff, D. C., Henderson, D. C., & Amico, E. (1992). Cigarette smoking in schizophrenia: relationship to psychopathology and medication side effects. American Journal of Psychiatry, 149(9), 1189-1194. Goldberg, J., Moll, S., & Washington, A. (1996). Exploring the challenge of tobacco use and schizophrenia. Psychiatric Rehabilitation, 1, 51-63. Grant, B. F., Hasin, D. S., Chou, S. P., Stinson, F. S., & Dawson, D. A. (2004). Nicotine Dependence and Psychiatric Disorders in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61(11), 1107-1115. Gurpegui, M., Martinez-Ortega, J. M., Jurado, D., Aguilar, M. C., Diaz, F. J., & de Leon, J. (2007). Subjective effects and the main reason for smoking in outpatients with schizophrenia: a casecontrol study. Comprehensive Psychiatry, 48(2), 186-191. Himelhoch, S., & Daumit, G. (2003). To whom do psychiatrists offer smoking-cessation counseling? American Journal of Psychiatry, 160(12), 2228-2230. Joukamaa, M., Heliovaara, M., Knekt, P., Aromaa, A., Raitasalo, R., & Lehtinen, V. (2001). Mental disorders and cause-speciﬁc mortality. British Journal of Psychiatry, 179(6), 498-502. Lasser, K., Boyd, J. W., Woolhandler, S., Himmelstein, D. U., McCormick, D., & Bor, D. H. (2000). Smoking and mental illness: A population-based prevalence study. Journal of the American Medical Association, 284(20), 2606-2610. Morris, C. D., Waxmonsky, J., May, M., Giese, A., & Martin, L. (Updated 2009). Smoking Cessation for Persons with Mental Illnesses: A Toolkit for Mental Health Providers. Denver, CO: State Tobacco Education and Prevention Partnership. Morris, C. D., Waxmonsky, J. A., Graves, M. G., & Giese, A. A. (In press). What Do Persons with Mental Illnesses Need to Quit Smoking? Mental Health Patient and Provider Perspectives. Psychiatric Rehabilitation Journal. National Association of State Mental Health Program Directors Council. (2006). Morbidity and Mortality in People with Serious Mental Illness. Parks J, Svendsen D, Singer P, Foti ME, eds. Technical Report 13. Alexandria VA: National Association of State Mental Health Program Directors Council. Prochaska, J. J., Delucchi, K., Hall, S. M. (2004). A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. Journal of Consulting and Clinical Psychology, 72(6), 1144-56. Schroeder, S. A. (2007). Shattuck Lecture. We can do better— Improving the health of the American People. New England Journal of Medicine, 357(12), 1221–8. Smith, G. L. (1996). Schizophrenia, smoking, and boredom. American Journal of Psychiatry, 153(4), 583-584. U.S. Department of Health and Human Services (2004). The health consequences of smoking: A report of the surgeon general U.S. Department of Health and Human Services, P.H.S. Ofﬁce of the Surgeon General. Ziedonis, D.M., Kosten, T., Glazer, W., et al (1994). Nicotine dependence and schizophrenia. Hospital and Community Psychiatry, 45, 204–206. Ziedonis, D., Williams, J. M., & Smelson, D. (2003). Serious mental illness and tobacco addiction: a model program to address this common but neglected issue. American Journal of the Medical Sciences., 326(4), 223-230. DID YOU KNOW? k Obesity-related illnesses, like diabetes, are an epidemic within an epidemic among the mentally ill. For example, about 13% of schizophrenic adults in their 50s have received a diabetes diagnosis, compared with 8% of the general population of the same age. NATIONAL COUNCIL MAGAZINE • WINTER 2009/ 49
National Council Magazine - Winter 2009

Table of Contents for the Digital Edition of National Council Magazine - Winter 2009
