Opinions

Smoking and mental health: the brick wall of “buts”

Written by: Mary-Grace Burinski, Development Lead – Inequalities, ASH Scotland

Published: 11/10/2016

The links between smoking and mental health are explored in our latest opinion piece.

“I hear what you’re saying, but…….my life is just shit.  Why would I want to live any longer?”

This is a genuine quote from a one of our recent focus groups.  So how should we respond to that?  Maybe we shouldn’t.  Maybe we should just accept that for some, smoking is perceived as providing a little bit of comfort in what would more accurately be described as an existence rather than a lifestyle.  Not everyone has the good fortune to live a ‘life’ with a family, a home, a garden, a car, a job, friends.  But should this mean we just never talk about smoking?  For every one who says ‘no’ we believe there are another two who would say ‘yes, I want to stop’.

Over recent months, we at ASH Scotland have spent a lot of time talking to anyone who would listen about the importance of smoking and mental health.  It’s something that really, really matters to us.  We know that people with mental health issues are dying prematurely because of a smoking intervention gap.  Over 10,000 people a year in Scotland die prematurely because of tobacco, suggesting that several thousand people in Scotland with mental health issues die prematurely each year because of smoking.

So why can it be difficult to shift the focus?

“but…….it helps with stress/boredom/anxiety”

This is probably the most common response we hear.  But smoking is an addiction with a cycle of withdrawal and gratification just like any other.  So when layered on top of any additional underlying issues, this short term relief brings the perception that it helps, when really the overall effect is actually bad for mental and physical health alike.

“but…….there are just more important priorities”

Of course we all have priorities.  We’ve all got targets and milestones to work towards.  That is why we are delighted to finally see an acknowledgment within the draft mental health strategy of the links between smoking and mental health.  That gives us the long overdue hook to engage organisations who previously haven’t considered these links.

“but……it’s the least of their worries”

Is it?  There’s more to smoking than the well documented physical health effects.  There are specific links between smoking and mental health.  At least one-third of all tobacco consumed in the UK is used by people with mental health issues.  About 70% of people who have a diagnosis of schizophrenia smoke tobacco.  Smoking is also associated with poorer outcomes of those living with bipolar disorder and is over-represented amongst people experiencing depression.

Then we come to the wider inequalities.

Smoking rates in the most deprived areas in Scotland are still at around 35-40%, the same levels we were seeing for the whole population in the 1970s.  If the smoking rates in the poorest areas fell by just 1%, these communities would save £12.5 million a year.  Put simply, smoking makes poverty and other inequalities worse.

So if there is one thing we could ask you to do, please stop thinking about the ‘buts’ and start thinking about the possibilities.  And if you’re interested, we can help you.  Through our IMPACT Project (Improving Mental and Physical health: Achieving Cessation Targets) we’ve been developing guidance for use by third sector community mental health organisations. The hope is this guidance will encourage conversations about the effect of smoking on mental health, so that everybody has an equal chance to be supported in improving their wellbeing – and to live longer, healthier lives.

For more information about the IMPACT Project, please contact mburinski@ashscotland.org.uk

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