Smoking among U.S. adults with mental illness 70 percent higher than for adults with no mental illness

Studies show need for enhanced prevention and quitting efforts for people with mental illness

Adults with some form of mental illness have a smoking rate 70 percent higher than adults with no mental illness, according to a Vital Signs report released today by the Centers for Disease Control and Prevention in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA). The report finds that 36 percent of adults with a mental illness are cigarette smokers, compared with only 21 percent of adults who do not have a mental illness.

According to the report, nearly 1 in 5 adults in the United States – about 45.7 million Americans—have some type of mental illness. Among adults with mental illness, smoking prevalence is especially high among younger adults, American Indians and Alaska Natives, those living below the poverty line, and those with lower levels of education. Differences also exist across states, with prevalence ranging from 18.2 percent in Utah to 48.7 percent in West Virginia.

Combined data from SAMHSA’s 2009–2011 National Survey on Drug Use and Health (NSDUH) were used to calculate national and state estimates of cigarette smoking among adults aged 18 years and older who reported having any mental illness. Mental illness was defined as having a diagnosable mental, behavioral, or emotional disorder, excluding developmental and substance use disorders, in the past 12 months.

“Smokers with mental illness, like other smokers, want to quit and can quit,” said CDC Director Tom Frieden, M.D., M.P.H. “Stop-smoking treatments work-and it’s important to make them more available to all people who want to quit.”

The report confirms that on average adult smokers with mental illness smoke more cigarettes per month than those without mental illness (331 vs. 310 cigarettes).  Adult smokers with mental illness are also less likely to quit smoking cigarettes than adult smokers without mental illness.

“Special efforts are needed to raise awareness about the burden of smoking among people with mental illness and to monitor progress in addressing this disparity,” said SAMHSA Administrator Pamela S. Hyde.

To address the high rates of tobacco use among persons with mental illness, SAMHSA, in partnership with the Smoking Cessation Leadership Center (SCLC), has developed a portfolio of activities designed to promote tobacco cessation efforts in behavioral health care.  SAMHSA and the SCLC developed and implemented the 100 Pioneers for Smoking Cessation Campaign, which provide support for mental health facilities and organizations to undertake tobacco cessation efforts. 

SAMHSA and the SCLC expanded the Pioneers Campaign by working with states through Leadership Academies for Wellness and Smoking Cessation, whose goal is to reduce tobacco use among those with behavioral health needs and staff. Participating states bring together policymakers and stakeholders (including leaders in tobacco control, mental health, substance abuse, public health, and consumers) to develop a collaborative action plan.

CDC also works closely with national partners, state tobacco control programs, and other stakeholders to address smoking among individuals with mental illness.  For example, the Break Free Alliance, a CDC grantee, is working with national partners to address tobacco use in this population.

Cigarette smoking continues to be the leading cause of preventable death and disease in the United States and throughout the world.  Cigarette smoking is responsible for an estimated 443,000 deaths in the United States each year.

For quitting assistance, call 1-800-QUIT-NOW (1-800-784-8669) or visit www.smokefree.gov. Also, visit www.BeTobaccoFree.gov for information on quitting and preventing children from using tobacco.

Vital Signs is a CDC report that appears on the first Tuesday of the month as part of the CDC journal Morbidity and Mortality Weekly Report, or MMWR. For a video clip of the Vital Signs’ report on cigarette use among U.S. adults with mental illness, please visit http://www.cdc.gov/media/subtopic/audioVideo.htm. The report provides the latest data and information on key health indicators. These indicators include cancer prevention, obesity, tobacco use, motor vehicle passenger safety, prescription drug overdose, HIV/AIDS, alcohol use, health care–associated infections, cardiovascular health, teen pregnancy, food safety and viral hepatitis.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES