Partnering with mental health recovery community to de-normalize tobacco use

Audience: All tobacco control and mental health staff

Key Points:

The San Mateo County (California) Tobacco Prevention Program partners with local behavioral health community efforts to advance physical well-being.  50% of 549 local clients at one service agency were regular smokers- consistent with smoking rates in the literature and tobacco as the major contributor to the 25-year shorter average lifespan for people living with mental illness and/or addiction issues.

Focus groups were conducted at a mental health clubhouse and two substance treatment centers to assess perceived tobacco use benefits and barriers among 53 consumer participants.

Respondents indicated that quitting is complicated by environmental cues from other smokers, and that sharing cigarettes is a normalizing action and a bonding opportunity.  Boredom and the positive cultural associations with smoking were voiced as reasons for continued tobacco use.  Cigarette smoking as a sign of freedom (particularly when leaving locked facilities) was another maintaining factor.

Respondents identified tobacco addiction as a replacement for other substances and a method of self-medication, but additionally stated that tobacco use can trigger a drug relapse.  The majority of substance use recovery respondents recommended treatment programs should be tobacco-free, as they perceived smoking breaks as inconsistent with the goal of wellness.

Educational Experience: Participants will review focus group findings and explore interventions attempted to address the issue.

 

Benefits:

Implications for the field include a consumer mandate for smoke-free policies and better understanding of points of cessation intervention.  Several local attempts to address this tobacco use disparity will be shared.