Mental Health Providers May Not Know Smokers Want to Quit

Crushed cigarette on groundMental health providers may not recognize a desire to quit smoking among people in therapy, according to a study published in Community Mental Health Journal. Although the majority of smokers seeking care at one of four community mental health clinics wanted to quit, few providers were aware of this desire.

About 57% of adults with mental health issues are smokers. Among United States adults in general, the number is much lower (15%).

Do Therapists Do Enough to Aid Smoking Cessation?

Researchers surveyed 213 people undergoing therapy at four community mental health clinics in and around St. Louis, Missouri. Eighty-two percent of respondents who smoked said they were interested in quitting. Forty-four percent were interested in trying medication to quit smoking, but just 13% received it. Twenty-five percent wanted to try counseling to quit, but only 5% received counseling.

Half wanted to try electronic cigarettes to help them quit, and 22% used e-cigarettes at the time of the survey. However, research does not clearly show whether electronic cigarettes are effective in helping people quit smoking.

Investigators also surveyed mental health providers about smoking cessation attitudes of people in therapy. The overwhelming majority of mental health providers surveyed believed people in therapy were uninterested in quitting, with 91% of psychiatrists and 84% of caseworkers saying people in therapy did not want to quit or reduce smoking.

The study’s authors point to the disconnect between the desires of people in therapy and provider impressions. This disconnect might present a missed opportunity to provide treatment. People with serious mental health diagnoses can die as many as 25 years earlier than people in the general population, so the researchers say smoking cessation is an urgent mental and physical health need for this population.

Smoking and Mental Health

According to 2005-2008 research by the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention (CDC), depression and other mental health diagnoses are highly prevalent among smokers. For example, 55% of male smokers ages 40-54 have depression, and 43% of female smokers in the same age group also have depression.

Household smoking rates increase as depression severity increases, according to the CDC. People with depression were less likely to successfully quit, and they smoked more cigarettes than their smoking peers without depression.

Many smokers experience temporary depression and anxiety when they quit, potentially making quitting more challenging for smokers with a mental health condition.


  1. Chen, L., Baker, T., Brownson, R. C., Carney, R. M., Jorenby, D., Hartz, S., . . . Bierut, L. J. (2016). Smoking cessation and electronic cigarettes in community mental health centers: Patient and provider perspectives. Community Mental Health Journal. doi:10.1007/s10597-016-0065-8
  2. Many smokers with serious mental illness want to kick habit. (2016, December 29). Retrieved from
  3. Pratt, L. A., PhD, & Brody, D. J., MPH. (2010, April). Depression and smoking in the U.S. household population aged 20 and over, 2005-2008 [PDF]. Hyattsville: Centers for Disease Control and Prevention National Center for Health Statistics.

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • beth

    January 4th, 2017 at 12:53 PM

    I have found that the pain of quitting tobacco is unique. People say it is all in your mind. I say it is all in your body. Normally your mind creates pain as a warning, that something is wrong. But with addiction and the intensity of craving that comes with addictive substances, your best interest is not considered when the MIND is persuaded to agree with the bodies strong desire or sometimes a varying degree of (physical dependency) then sounding the false alarm that there is an eminent danger or an emergency which requires immediate attention. We may have knowledge that the substance is harmful and that it not something we should be consuming, yet the mind and the pain we feel send us a contrary message. The mind, creates pain. We find ourselves doubting the true information we have on that addictive and poisonous substance. This can be confusing, distressful, a progressively desperate stalemate situation, which comes with pain of its own which screams its demands for the substance in question. But, there is such a thing as good pain. And this, is the case with what Ill call ‘pestilent substances,’ which we feel we (must have but that will hurt or kill us if we consume them.) This is the pain of healing. The result of good pain is new and better life, and more of it. The educated approach is the best way to go with this pain. So, cold turkey got good pain? Ans: abstain

  • beth

    January 4th, 2017 at 1:03 PM

    you gotta wanna quit. That way, you get what you want. Its phantom pain, and its not something you do. its something you don’t do. love Beth, free from tobacco 18 years. best thing ive ever done. P.S. lots of raw fruit really helps beat the craving pain

  • Molly

    January 4th, 2017 at 5:04 PM

    Hello these are mental health care providers, not mind readers

  • Jeffrey M

    January 5th, 2017 at 6:24 PM

    Their time would be better spent delivering therapy to help smokers deal with the insane bullying this moral panic crusade has unleashed. The compulsory peak fitness brigade – publicly funded parasites on the health system – are way past due for a serious smack down.

    Abuse and assaults against smokers are now a daily occurrence. The mentally ill are the last people who deserve to be attacked and vilified by these prodnose vigilantes.

  • John C.

    January 6th, 2017 at 6:24 PM

    Much a do…….but not about nothing……..this procedure could be carried out at the initial assessment on the patient’s admission to hospital……just add another question to the assessment form!

  • Cal

    January 9th, 2017 at 4:55 AM

    Who knows? Maybe treatment for one thing could actually help to alleviate the smoking habit even if it is not specifically addressed.

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