When we talk about an addiction to cigarettes, we often note how the three-link chain of physical, mental, and social components plays a role. However, for the one in three smokers who have a diagnosed mental illness such as depression, anxiety, or schizophrenia, this three-link chain of addiction may be composed of additional components that may make it particularly difficult to quit.
To be clear: many smokers with mental illness do want to quit, and we’re here to help! If you are a smoker with a mental illness, understanding the barriers to quitting smoking and how those barriers present unique challenges to you may help you start your quit journey.
The Physical Barrier
Cigarettes contain an addictive chemical called nicotine. In the brain, nicotine causes the immediate release of a chemical called dopamine, making you feel good. Nicotine’s mood-altering effects put those with mental illness at higher risk for cigarette use and nicotine addiction.
People experiencing mental health issues have unique brain chemistry that may increase their tendency to use nicotine, making it more difficult to quit and complicate withdrawal symptoms. Whether you have been diagnosed with a mental illness or not, speaking to a healthcare provider – such as your primary care doctor or a mental health specialist like a psychologist or psychiatrist – about ways to help break the addiction to nicotine may help increase your chances of quitting.
The Social Barrier
Many people smoke to feel like they are “part of a group” and may be afraid that quitting tobacco will affect their friendships. Some may have developed relationships with others while in mental health or substance use treatment settings, where smoke breaks are often informal meeting places after group sessions. Though many of your friends may smoke, and you may find it tempting to join them, remind yourself that you’re making these choices for your health. It’s okay to pull back on friends who are smokers while you go through the early stages of quitting. We’re not saying never be friends or go out with them again – just try to avoid pressures to smoke in the short term.
Additionally, smoking is often associated with social activities, including drinking alcohol. But for smokers with mental illness, alcohol is not recommended – especially if you take certain psychiatric medications. Take steps to remove yourself from environments where people may be smoking or drinking. It’s also important to let your friends know that you’re planning to quit smoking, and ask them to refrain from smoking or drinking around you. Explain to them why you’re taking this important measure to improve your health, and what their support would mean. Ask them instead to meet you in locations or for hobbies that are less likely to encourage smoking – like seeing a movie or kayaking. Maybe they’ll even want to quit with you, giving you a chance to push each other. Quitting smoking also gives you time to try a new hobby where you can make new friends as well.
The Behavioral Barrier
Many smokers light up at specific times of day or during certain activities – such as when drinking coffee or driving – or when they’re feeling a certain way, like stress or fatigue. People with mood disorders such as depression may have trouble participating in activities, leading them to become bored and smoke more to keep themselves busy. Tobacco use is perceived to relieve feelings of tension and anxiety and is often used to cope with stress, including in a routine location such as the workplace.
Quitting smoking often means relearning or adjusting these behaviors, which may be a difficult hurdle to overcome. To start, write down the times and locations in which you smoke most often. Then, plan alternative routes and activities to help you handle those routine urges. Find something else to do with your hands and mouth to keep your mind occupied at work, instead of going for a smoke.
The Financial Barrier
People with mental illness are not only more likely to smoke, but are also more likely to be low-income, with 47.9 percent of those with mental illness living below the poverty level. But no matter your financial situation, quitting smoking can save you money. At a national average of $6.28 per pack, smoking adds up – which means that quitting adds up, too.
Affordable healthcare options such as Medicaid are available to help low-income smokers kick the habit by providing coverage for cessation products. Additionally, all states now mandate that public housing be smokefree. That means smokefree air for you and everyone around you, no matter where you live.
There are many misconceptions about quitting smoking that may hold someone with a mental illness back from getting the support they need. If you have other worries, such as the fear of weight gain, arm yourself with the information you need to get over the feeling. Starting taking the small steps to overcome those barriers and get a smokefree start.