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Smoking and nicotine dependence

Studies suggest that up to 70% of mental health service user’s smoke, and commonly smoke heavily (20 or more a day). Many will have smoked for years, and will have tried their best to quit many times. But research also shows that mental health service users are keen to be offered help to quit and can see benefits (see below) to their health and wellbeing if they do. Mental health service users who smoke are not alone, and help is available to them to become ex-smokers.

Self-medication

Many smokers are concerned that quitting smoking will increase the symptoms associated with their illness and that smoking is actually easing their symptoms. In reality only a minority of people with depression who stop smoking experience an increase in depressive symptoms. Any short term benefits that smoking seems to have are far outweighed by the higher rates of smoking related physical health problems, such as lung cancer, that are common in people with mental health problems.

In people with a diagnosis of schizophrenia, there is little evidence to show any worsening of symptoms follows stopping smoking.

Evidence does show that the long term effects of smoking cessation on mental health are far from negative. Specifically, it has been shown that stopping smoking decreases the likelihood of both depressive and anxiety related symptoms

Smoking and your psychiatric medication

Because tobacco (not nicotine) speeds up the metabolism of some of the drugs used to manage mental health conditions, the levels of these drugs in your body can be affected if you quit smoking.If you are thinking about quitting speak to your GP/Psychiatrist or Care Coordinator before going ahead.

When people quit smoking they tend to need lower doses of drugs thereby reducing the side effects, a definite benefit of quitting smoking.

Some medications affected in this way are:Amitriptyline Clomipramine, Clozapine, Desipramine, Diazepam, Haloperidol, Imipramine. Mirtazapine, Olanzapine, Perphenazine, Propranolol, Zotepine.

The most important one to be concerned about is Clozapine as it is crucial that levels are monitored and maintained within very strict levels.

 

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