Au 20th century, a vision immediately struck the visitor entering a psychiatric ward for the first time: that of fingers and nails (even teeth) yellowed by cigarettes in many patients, inveterate smokers. People with psychiatric illnesses have “high rates of cigarette consumption and a high probability of dying” from a pathology linked to this addiction.
JAMA Psychiatry recalls that the last fifty years have however seen “a significant decline in smoking”, at least in the United States. But, the authors specify from this point of view, these reductions appear to be “unequally distributed” and the frequency of smoking still remains “high among people with psychiatric illnesses”, including among subjects suffering from other addictions.
The authors mention some edifying statistics on this subject: “in a large psychiatric hospital in Maryland, 62% of patients with schizophrenia smoke cigarettes; Tobacco-related pathologies are responsible for 53% of deaths among schizophrenic patients, 48% among bipolar subjects, and 50% among depressive patients admitted to Californian hospitals between 1990 and 2005.
Helping patients manage their tobacco addiction
As psychiatrists are thus concerned by this problem of smoking, since they have both, as doctors, the necessary skills to treat disorders linked to tobacco consumption and regular contact with these patients most likely to smoke, the authors therefore believe that “the assessment and treatment proposal for tobacco use disorders should be at the heart of psychiatric practice. »
As part of a psychiatric assessment, the authors recommend systematically identifying nicotine addiction, including in the form of electronic cigarettes, in order to assess to what extent smoking and nicotine withdrawal “contribute to the symptoms » justifying this intervention by the psychiatrist.
Patients who quit smoking can, the authors believe, “limit tobacco-related illnesses, avoid the painful effects of withdrawal or cravings, and live longer.” » Constituting “a priority for psychiatrists”, this dual objective (improving the quality of existence and life expectancy) involves helping patients to better manage their tobacco dependence.
