Researchers believe that a combination of biological, psychological and social factors contribute to increased tobacco use among persons with behavioral health conditions.1
- Persons with mental health conditions have unique neurobiological features that may increase their tendency to use nicotine, make it more difficult to quit and complicate withdrawal symptoms.
- Nicotine affects the actions of neurotransmitters (e.g. dopamine). For example, people with schizophrenia who use tobacco may experience fewer negative symptoms (lack of motivation, drive and energy).
- Nicotine also enhances concentration, information processing and learning. This is especially appealing to individuals with psychotic disorders for whom cognitive dysfunction may be a part of their illness or a side effect of antipsychotic medications.
- Other biological factors include nicotine’s positive effects on mood, feelings of pleasure and enjoyment. Some evidence also suggests that smoking is associated with a reduced risk of antipsychotic-induced Parkinsonism.
- Tobacco use may temporarily relieve unpleasant feelings of tension and anxiety and is often used to cope with stress.
- People develop a daily habit of tobacco use and changing habits can be difficult.
- Individuals with behavioral health conditions are likely to come in contact with other people using tobacco through treatment programming and this may normalize the use of tobacco as well as make individuals feel like they are “part of a group.”
- Individuals with behavioral health conditions may also live in environments (e.g., supported housing) where tobacco use is common and this may create additional challenges to living tobacco-free.
- Individuals with behavioral health conditions may have greater challenges accessing healthcare and community resources to support a tobacco-free lifestyle.
 Morris, C.D., Morris, C.W., Martin, L.F., Lasky, G.B. (2013) DIMENSIONS: Tobacco Free toolkit for Healthcare Providers: Supplement - Priority Populations: Behavioral Health. University of Colorado Anschutz Medical Campus, School of Medicine, Behavioral Health and Wellness Program.
For other wellness-related toolkits visit http://www.bhwellness.org/resources/toolkits/