Dr Kam Dhillon Head of Research. Taking a deep breath Smoking cessation and diagnosed mental health problems. Smoking and Mental Health. In the general population adult tobacco use is in decline, more so since the ban.
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Within 10 seconds of inhaling tobacco smoke, nicotine reaches the brain and acts on specific neurons and releasing noradrenalin and dopamine that act as stimulants. This can lead to improved mood, concentration, decreased anxiety and stress.
This is more illusionary than real. Withdrawal symptoms kick in and are relieved by more smoking. Over time tolerance goes up and more nicotine is needed for ‘normal’ state.
Cravings feel stressful and smoking feels relaxing - self medication is established.
Tobacco kills around 87,000 people annually in England alone (Smoke free England – One year on, DH, July 2008).
Compliance to the legislation has been high.
Local NHS Stop Smoking services have had a 20% increase in demand.
We do not know how people with mental health problems have fared since the smoking ban.
People are smoking outside psychiatric settings, like others in other clinical settings.
GPs now minded to record smoking prevalence and PCTs asked to increase prescribing of stop smoking products, encourage more smoke-free work places and target high risk groups (DH, 23rd September 2008).
Recognise that the traditional approaches do not work as there appears a different and stronger relationship with nicotine.
Explore with people this relationship with nicotine – employ CBT oriented strategies with greater flexibility – combination approaches successful – keep mental health in the foreground, accounting for different vulnerabilities.
Confidence building and stress management activities are helpful.
Be aware of your capabilities and scope of work and refer to and work with other professionals.