For more than half a century it has been assumed by the psychiatric community that allowing people in psych hospitals and treatment centers to smoke was a good idea. This was based on several untested assumptions — common sense, if you will — never a good idea when it comes to mental health issues, including addiction.
One assumption was that patients were calmed by smoking, and that encouraging or forcing them to stop would put them under too much stress and exacerbate their mental health issues or, in the case of addicts, interfere with their recovery. This doctrine was even taken to the extreme of psychiatrists being encouraged to smoke with their patients, in order to foster a feeling of fellowship and solidarity.
It turns out (none-too-surprisingly) that the majority of people confined to psychiatric hospitals die, not from the effects of their psychiatric disorders, but from smoking-related causes such as emphysema, heart problems, and lung cancer. Alcoholics and other addicts are also high on the list for these disorders. Rather more surprising is the fact that people with mental health and addiction disorders are responsible for consumption of nearly half the cigarettes sold in the United States.
However, it turns out that the assumption that patients couldn’t tolerate the effects of quitting is totally bogus. In fact, it turns out — based on recent studies of patients in Scandinavia who were introduced to smoking-cessation programs — that patients respond successfully if properly motivated, if nicotine replacement therapy (“the patch”) is available to make the transition easier, and if supportive counseling is available. It was also found that, if anything, quitting cigarettes improved their mental state and that many were enthusiastic about the idea of quitting.
The improvement is thought to involve participants’ enhanced feelings of self-esteem and control over their own lives. In psych patients it was undoubtedly due, as well, to the elimination of repeated withdrawal. Patients in psych hospitals and wards are not permitted to smoke all the time. There are usually supervised smoke breaks about every 4 hours. The result is that the smokers are stressed several times a day by nicotine withdrawal, which sets in within an hour after the last smoke. Those cravings cause them to smoke even more during the breaks, building up the nicotine, carbon monoxide and other chemicals in their blood to levels higher than those of most chronic smokers. Then they go through the cycle all over again. (This is also true, incidentally, in many employment settings.)
In addition to the withdrawal, nicotine causes much faster elimination of several commonly-used psych meds. In fact, it is likely that the “improvement” often reported in psychiatric patients when they are allowed to smoke is in fact due to the reduction of depressants like Haldol, often used to calm patients as a matter of convenience.
In yet another…ah…surprise, it turns out that the tobacco industry has been pushing cigarettes on the psychiatric treatment community for more than half a century, even hosting seminars to educate practitioners about their “benefits.” Thus, we can look for some powerful push back against these new findings. After all, psychiatric patients and addicts are literally their most valuable customers.
Nonetheless, maybe it is time for alcohol and addiction treatment to consider these results. After all, smoking is the number one worldwide cause of preventable death. And really, isn’t it just a bit ingenuous to claim to foster sobriety while allowing patients to avoid treatment for the most dangerous addiction of all?
Nicotine is the tobacco plant’s natural protection from being eaten by insects. Its widespread use as a farm crop insecticide is now being blamed for killing honey bees. A super toxin, drop for drop it is more lethal than strychnine or diamondback rattlesnake venom and three times deadlier than arsenic. Yet amazingly, by chance, this natural insecticide’s chemical signature is so similar to the neurotransmitter acetylcholine that once inside the brain it fits a host of chemical locks permitting it direct and indirect control over the flow of more than 200 neuro-chemicals, most importantly dopamine.
I smoked for thirty years, and I quit. You can too! Are you really clean and sober if you’re using one of the most deadly drugs known?
Nicotine has just about everything going for it in the addiction department.
First of all, it’s legal, and even though it is becoming inconvenient to smoke, you can still have a smoke pretty much when you need one.
Second, and very much related to our first reason, are two factors: Continue reading
Tobacco products are the only products legally sold in the United States that are known to be deadly when used as directed .
That being the case, how can anyone who is still using them claim to be in recovery from addiction?
Addiction is addiction, and denial is denial. Get over it. I’m not saying you have to quit everything all at once, but if you’ve been off the sauce or drugs for more than a couple of years and are still smoking, don’t be bragging about how you’re a “recovered” addict. You ain’t there yet, my friend.
And just in case you think I don’t know what it’s about — I smoked two packs a day for 30+ years.