Living with a mental illness can be difficult, and some people may turn to smoking as a way to cope with symptoms they are experiencing. Results from a surveys have shown that smoking is used as a coping mechanism in adults with mental illnesses at a higher rate than those who don’t have a mental illness.
People with mental health problems, including anxiety, depression or schizophrenia are much more likely to smoke than the general population and tend to smoke more heavily. They die on average 10 to 20 years earlier than those who don't experience mental health problems. While this may help us conclude the people with mental illnesses tend to smoke more, we can also say that smoking itself can lead to increase in anxiety and tension. People who smoke are more likely than nonsmokers to have experienced anxiety, panic, stress, depression, or suicidal thoughts. The challenges of quitting smoking can also lead to increased stress and anxiety. Quitting, though, can increase the effectiveness of certain medications — particularly those used for depression, anxiety, and psychotic disorders — as tobacco smoke affects how some are absorbed and how fast they are used by your body.
Smokers are also more likely than non-smokers to develop depression over time because nicotine in the tobacco interferes with chemicals in the brain. It mimics acetylcholine, increasing signaling in the brain and is also known to increase the dopamine release in the body which gives a pleasurable feeling. When smokers haven't had a cigarette for a while, the craving for another one makes them feel irritable and anxious. These feelings can be temporarily relieved when they light up a cigarette. So smokers associate the improved mood with smoking. In fact, it's the effects of smoking itself that's likely to have caused the anxiety in the first place. Cutting out smoking can therefore improve mood and reduce anxiety.
Smoking is a global public health concern. About 1.1 billion people smoke worldwide, which is expected to rise to more than 1.6 billion by 2025. In. Bangladesh it causes huge premature deaths and poses considerable economic burden among the poor people. Premature deaths and economic burden are directly affected by the use of tobacco in the form of smoking, but are there any measures to combat the effects it has on the mental health of an individual? Research suggests that most smokers are aware of the negative effects smoking has on them and the threats of second-hand smoking. They have confessed that they would like to give up smoking considering the negative effects of smoking in the long term and the threat of secondhand smoking on their families and friends around them, but smoking helps them cope with anxiety and stress.
We are familiar about the physical effects of tobacco and that it leads to diseases such as cancer, heart disease, stroke, lung disease, diabetes as well as puts people at a higher risk for contracting tuberculosis. We can say that it harms nearly every part of the body. In fact, recent studies have shown that tobacco used in any form, smoking or chewing, has made the treatment of such COVID-19 patients more challenging due to their rapid clinical deterioration. “Smokers have up to a 50% higher risk of developing severe disease and death from COVID-19, so quitting is best thing smokers can do to lower their risk from this coronavirus, as well as the risk of developing cancers, heart disease and respiratory illnesses,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General on the World No Tobacco Day, for which WHO has a “commit to quit” campaign currently working directly with 29 focus countries. Each country agreed with WHO on selected activities, including, running national awareness campaigns, releasing new digital tools, revising policies, engaging youth, training health workers, opening new cessation clinics, supporting nicotine replacement therapies through WHO partners, establishing national toll-free quit lines, making quitting courses available, and more.
It can be concluded that smoking tobacco can exacerbate existing mental and physical health challenges in the short term and lead to additional negative outcomes down the road. Strategies that address mental illness among smokers are important for tobacco control. As the majority of smokers with mental illness are not in contact with mental health services for their condition, we need to address mental illness as a part of tobacco control efforts.
Dr. Sahar Raza is Senior Operations Officer. Eminence Associates for Social Development.
