The Imperative to Treat Tobacco Use Disorder

May 2024

The Imperative to Treat Tobacco Use Disorder

According to the Centers for Disease Control and Prevention, tobacco use disorder remains the leading cause of preventable disease, disability, and death in the United States, killing close to 500,000 Americans each year. While significant public health efforts have resulted in fewer people smoking and less tobacco consumed, in 2021 an estimated 11.5% of U.S. adults still smoked cigarettes. Tobacco use disorder and related complications historically have disproportionally affected people with serious mental illness. For too long, mental health clinicians have believed they need to choose between treating serious mental illness and treating tobacco use disorder. It is a false choice: clinicians have a responsibility to treat both.

This month’s Editor’s Choice Collection reflects on the treatment of tobacco use disorder for people with mental illness, with a special emphasis on addressing barriers to accessing this life-saving care. Such barriers are discussed in detail in articles listed in the first section, and articles in the second section highlight the roles of peers and community health workers. The third section outlines key clinical interventions. As this collection illustrates, psychiatric providers should be leaders at the forefront of managing tobacco use disorder.

Emily Kager, M.D., Joseph Kim, M.D., and Peter Spyrou, M.D., Lisa B. Dixon, M.D., M.P.H.

Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Bronx, New York (Kager, Kim, Spyrou). Dr. Dixon is the editor of Psychiatric Services.

Browse all Editor’s Choice collections

IDENTIFYING AND ADDRESSING BARRIERS TO CARE

Integrated Care: Tobacco Use and Mental Illness: A Wake-Up Call for Psychiatrists
Jill M. Williams, M.D., T. Scott Stroup, M.D., M.P.H., Mary F. Brunette, M.D., Lori E. Raney, M.D.
2014, Volume 65, Issue 12, pp 1406–1408

Cigarette Smoking by Patients With Serious Mental Illness, 1999–2016: An Increasing Disparity
Faith Dickerson, Ph.D., M.P.H., Jennifer Schroeder, Ph.D., Emily Katsafanas, B.S., Sunil Khushalani, M.D., Andrea E. Origoni, B.A., Christina Savage, M.A., Lucy Schweinfurth, B.A., Catherine R. Stallings, R.N.C., M.A., Kevin Sweeney, B.S., Robert H. Yolken, M.D.
2017, Volume 69, Issue 2, pp 147–153

Barriers to Implementing Evidence-Based Smoking Cessation Practices in Nine Community Mental Health Sites
Seth Himelhoch, M.D., M.P.H. Julia Riddle, B.A. Howard H. Goldman, M.D., Ph.D
2014, Volume 65, Issue 1, pp 75–80

Lung Cancer Screening Eligibility, Risk Perceptions, and Clinician Delivery of Tobacco Cessation Among Patients With Schizophrenia
Kelly E. Irwin, M.D., M.P.H., Eleanor B. Steffens, M.P.H., YooJin Yoon, B.S., Efren J. Flores, M.D., Helen P. Knight, M.D., William F. Pirl, M.D., M.P.H., Oliver Freudenreich, M.D., David C. Henderson, M.D., Elyse R. Park, Ph.D., M.P.H
2019, Volume 70, Issue 10, pp 927–934

COMMUNITY- AND PEER-DRIVEN MODELS

A Pragmatic Cluster-Randomized Trial of Provider Education and Community Health Worker Support for Tobacco Cessation
A. Eden Evins, M.D., M.P.H., Corinne Cather, Ph.D., Melissa Culhane Maravic, Ph.D., M.P.H., Sally Reyering, M.D., Gladys N. Pachas, M.D., Anne N. Thorndike, M.D., M.P.H., Douglas E. Levy, Ph.D., Vicki Fung, Ph.D., Michael A. Fischer, M.D., Kristina Schnitzer, M.D., M.P.H., Sarah Pratt, Ph.D., Michael D. Fetters, M.D., Bianca Deeb, M.S.W., Kevin Potter, Ph.D., David A. Schoenfeld, Ph.D.
2022, Volume 74, Issue 4, pp 365–373

Low-Burden Strategies to Promote Smoking Cessation Treatment Among Patients With Serious Mental Illness
Li-Shiun Chen, M.D., Sc.D., Timothy B. Baker, Ph.D., Jeanette M. Korpecki, R.Ph., Kelly E. Johnson, M.D., Jaime P. Hook, M.D., Ross C. Brownson, Ph.D., Laura J. Bierut, M.D.
2018, Volume 69, Issue 8, pp 849–851

Smoke Free Program at Massachusetts Mental Health Center: A Peer-Supported Approach
Mark Viron, M.D.
2016, Volume 67, Issue 6, pp 696–697

CLINICAL INTERVENTIONS

Smoking Cessation Medication Prescribing for Smokers With and Without Mental Illness
Sarah A. White, M.S.P.H., Elizabeth Stone, M.S.P.H., Karly A. Murphy, M.D., M.H.S., Gail L. Daumit, M.D., M.H.S., Emma E. McGinty, Ph.D.
2023, Volume 74, Issue 4, pp 332–340

Efficacy and Safety of Pharmacotherapeutic Smoking Cessation Aids in Schizophrenia Spectrum Disorders: Subgroup Analysis of EAGLES
A. Eden Evins, M.D., M.P.H., Robert West, Ph.D., Neal L. Benowitz, M.D., Cristina Russ, M.D., David Lawrence, Ph.D., Thomas McRae, M.D., M.S., Melissa Culhane Maravic, Ph.D., M.P.H., Jaimee L. Heffner, Ph.D., Robert M. Anthenelli, M.D.
2022, Volume 72, Issue 1, pp 7–15

Clinical Management of Tobacco Dependence in Inpatient Psychiatry: Provider Practices and Patient Utilization
Teresa M. Leyro, Ph.D. Sharon M. Hall, Ph.D. Norval Hickman, Ph.D., M.P.H. Romina Kim, B.S. Stephen E. Hall, M.D. Judith J. Prochaska, Ph.D., M.P.H.
2013, Volume 64, Issue 11, pp 1161–1165

Smoking Cessation Services and Smoke-Free Policies at Substance Abuse Treatment Facilities: National Survey Results
Yuyan Shi, Ph.D., and Sharon E. Cummins, Ph.D.
2015, Volume 66, Issue 6, pp 610–616

Smoking Cessation Counseling on Inpatient Psychiatric Units
Jordan T. Holler, B.S. Hannah Borowsky, B.A. Alissa Peterson, M.D.
2019, Volume 70, Issue 12, pp 1180–1180