title: Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report.
abstract: The National Institute of Mental Health (NIMH) convened a meeting in September 2005 to review tobacco use and dependence and smoking cessation among those with mental disorders, especially individuals with anxiety disorders, depression, or schizophrenia. Smoking rates are exceptionally high among these individuals and contribute to the high rates of medical morbidity and mortality in these individuals. Numerous biological, psychological, and social factors may explain these high smoking rates, including the lack of smoking cessation treatment in mental health settings. Historically, "self-medication" and "individual rights" have been concerns used to rationalize allowing ongoing tobacco use and limited smoking cessation efforts in many mental health treatment settings. Although research has shown that tobacco use can reduce or ameliorate certain psychiatric symptoms, overreliance on the self-medication hypothesis to explain the high rates of tobacco use in psychiatric populations may result in inadequate attention to other potential explanations for this addictive behavior among those with mental disorders. A more complete understanding of nicotine and tobacco use in psychiatric patients also can lead to new psychiatric treatments and a better understanding of mental illness. Greater collaboration between mental health researchers and nicotine and tobacco researchers is needed to better understand and develop new treatments for cooccurring nicotine dependence and mental illness. Despite an accumulating literature for some specific psychiatric disorders and tobacco use and cessation, many unstudied research questions remain and are a focus and an emphasis of this review.
authors.affiliation: University of Massachusetts Medical School and UMass Memorial Health Care, Worchester, MA01655, USA. ziedonid@ummhc.org
authors.forename: Douglas
authors.initials: D
authors.lastname: Ziedonis
authors.forename: Brian
authors.initials: B
authors.lastname: Hitsman
authors.forename: Jean C
authors.initials: JC
authors.lastname: Beckham
authors.forename: Michael
authors.initials: M
authors.lastname: Zvolensky
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Adler
authors.forename: Janet
authors.initials: J
authors.lastname: Audrain-McGovern
authors.forename: Naomi
authors.initials: N
authors.lastname: Breslau
authors.forename: Richard A
authors.initials: RA
authors.lastname: Brown
authors.forename: Tony P
authors.initials: TP
authors.lastname: George
authors.forename: Jill
authors.initials: J
authors.lastname: Williams
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Calhoun
authors.forename: William T
authors.initials: WT
authors.lastname: Riley
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D028642:Persons with Psychiatric Disorders / Q000523:psychology / Q000706:statistics & numerical data*; D009315:National Institute of Mental Health (U.S.); D015995:Prevalence; D011322:Primary Prevention / Q000706:statistics & numerical data; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology; D020377:Self Efficacy; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology / Q000706:statistics & numerical data*; D012931:Social Environment; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology