The negative impact of smoking on mental health is no longer in doubt, and should be addressed by government policy, experts have said.
Smoking increased the risk of developing schizophrenia by between 53%-127% and of developing depression by 54%-132%, findings from the University of Bristol have suggested.
The evidence presented at the Royal College of Psychiatrists International Congress this week (20 June) has been shared with the Government, which is developing a Tobacco Control Plan for publication later this year.
Professor Marcus Munafo, professor of biological psychology at the University of Bristol, an author of the research, said: ‘There is no longer any doubt that smoking is bad for mental health and this needs to be a priority in the forthcoming Tobacco Control Plan.
‘Those working with people with mental health conditions need to understand and address the vicious cycle of bidirectional effects, whereby having symptoms of mental illness causes individuals to smoke more and to be more likely to become addicted.
‘At the same time, smoking also increases the risk of subsequent mental illness and exacerbates mental health symptoms. Lower rates of smoking will improve overall levels of good mental health as well as physical health.’
The report said more research was needed to identify why this is the case, and that more evidence was needed for other mental health conditions such as anxiety or bipolar disorder.
The Congress also heard new data on the numbers of smokers with mental health conditions. Rates of smoking are much higher among people with mental health conditions, and among England’s six million smokers there are an estimated 230,000 people with severe mental illness (e.g. schizophrenia and bipolar disorder), and 1.6 million with depression and anxiety.
Alongside the new report, a joint publication by Action on Smoking and Health (ASH) and the Royal College of Psychiatrists’ Public Mental Health Implementation Centre has set out how a public mental health approach to smoking can be taken.
The Government is considering recommendations by the Khan Review for the forthcoming Tobacco Control Plan to deliver its ‘smokefree 2030’ ambition. The independent review by Javed Khan was commissioned to help the Government identify the most impactful interventions to reduce the uptake of smoking, and support people to stop smoking.
Deborah Arnott, chief executive of ASH, said: ‘The Khan Review is called ‘Making Smoking Obsolete’ – this cannot be achieved if we ignore the more than a million smokers with mental health conditions. While the NHS has started to roll out support to quit for those with severe mental illness there is little provision for those with common mental health conditions like depression and anxiety – a plan is needed.’
Dr Adrian James, president of the Royal College of Psychiatrists, added: ‘Smoking addiction is not a trivial matter; it causes serious harm to both body and mind. Smokers with mental health conditions can quit with the right support from healthcare professionals.’
Given ‘the right tools,’ pharmacists and GPs are ‘confident’ smoking rates could be reduced in patients living with mental health conditions, a survey found earlier this year, which called for better training and resources to help healthcare professionals support this reduction.
The ’smokefree 2030’ target, meanwhile, could be missed by ‘decades’ if the Government does not take immediate action to boost NHS smoking cessation funding, an official review published earlier this month concluded.