1. Becoming Tobacco-Free for Recovery: Consumer and Provider Perspectives On Smoking Cessation Beth Lillard Amy F. Rogers Karen Balsamico, MA

2. Tobacco Use in the Mental Health Community Smokers suffering from mental illness account for nearly half (44.3%) of all cigarettes consumed in America. Adler, Olincy, et al. Schizophrenia Bulletin 24:196. 1998 The death rate among young adults with mental illness is more than triple that of their peers. Department of Mental Health, Massachusetts, 2001. For mentally ill clients 25-44 years old, heart disease was 7X higher than peers and more than 7x the suicide rate. Department of Mental Health, Massachusetts, 2001.

3. Tobacco Use in the Mental Health Community Smoking often influences the impact of psychotropic medications. Smokers may need higher doses, which can produce more negative side effects. Lasser, K., et al. JAMA, 284:2606-2610. November 2000 Recent studies show that smoking may precede mental illness. Boyd, W.J., et al. Psychiatric Times. 2001. Vol. XVII, Issue 10. Abstinence from tobacco is shown to be related to longer post-treatment abstinence from drugs and alcohol. (Stuyt, 1998; Sobel, 1996; NIDA Research Update, 2/2000)

4. What is Recovery? Symptom management Medication balancing Feeling more “a part of” Self-esteem Sense of self-efficacy, independence Safe and pleasant housing Work ~ volunteer and paid School Community

5. How Does Smoking Interfere? Adverse physical health consequences; robs energy Erodes self-esteem; persistent sense of being “stuck”, unable to make positive life changes Burns up precious money and time Works against possibility of reducing medications and unpleasant side-effects Stifles imagination for developing other interests Causes smoking-related isolation, reinforcing societal marginalization Closes off many desirable independent living situations Turns off an increasing number of prospective employers and volunteer coordinators

6. We CAN Quit Smoking! Comparative smoking cessation rates: Smokers with no history of mental illness 42.5% Smokers with any history of mental illness 37.1% Smokers with past-month mental illness 30.5% “Persons with mental illness are about twice as likely to smoke as other people but have substantial quit rates.” Lasser, K., et al. JAMA 284:2606-2610, November 2000

7. Contact information: Beth Lillard, Adult Tobacco Cessation Services Bay Area Community Resources blillard@bacr.org Amy F. Rogers, Buckelew Employment Services amy@buckelew.org Karen Balsamico, Enterprise Resource Center 415.457.4554