Journal
EXPERT REVIEW OF RESPIRATORY MEDICINE
Volume 11, Issue 10, Pages 841-850Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/17476348.2017.1361823
Keywords
Tobacco; smoking; nicotine; mental illness; substance use disorders; e-cigarette; dual diagnosis; nicotine replacement therapy; CYP1A2; quit-line
Categories
Funding
- National Cancer Institute [R01CA204356]
- National Heart, Lung, and Blood Institute [R01HL117736]
- State of California Tobacco-Related Disease Research Program [24RT-0035, 25IR-0032]
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Introduction: Tobacco remains the leading preventable cause of death in the US, accounting for over 520,000 deaths annually. While the smoking prevalence has declined over the past 50years, those with mental illness and addictive disorders continue to smoke at high levels and with significant tobacco-related health problems.Areas covered: This review highlights the epidemiology, contributing factors, and evidence-base for intervening upon tobacco use in those with mental illness and addictive disorders. Historically underprioritized, a growing body of literature supports treating tobacco within mental health and addiction treatment settings. Critically, treating tobacco use appears to support, and not harm, mental health recovery and sobriety. This review also summarizes novel, emerging approaches to mitigate the harms of cigarette smoking.Expert commentary: People with mental illness and addictive disorders have a high prevalence of tobacco use with serious health harms. Treating tobacco use is essential. Evidence-based strategies include individual treatments that are stage-matched to readiness to quit and combine cessation medications with behavioral therapies, supported by smoke-free policies in treatment settings and residential environments. Emerging approaches, with a focus on harm reduction, are electronic nicotine delivery systems and tobacco regulatory efforts to reduce the nicotine content in cigarettes, thereby reducing their addiction potential.
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