Considerably higher smoking rates are observed amongst people with a mental health problem relative to the general population. Research has shown individuals with a mental illness are about twice as likely to smoke as others who do not suffer from mental health issues 3.
According to the 2017-18 National Survey for Wales, respondents with a mental illness are defined as those who report that they have a long-standing mental health condition. The smoking prevalence within this group was 36% compared to the 19% reported among the whole of the adult population in Wales in 2017-18. In keeping with the pattern observed within the general population, males with a mental illness have a higher smoking prevalence rate than females (41% vs 34%), however the gender difference is more marked among those with a mental illness.
Evidence also suggests that together with a higher prevalence of smoking among people with a mental illness such individuals additionally smoke a higher number of cigarettes4.
It is very difficult to establish a causal relationship between smoking and mental health because many people begin smoking before they are diagnosed with a mental health illness. It has so far not been possible to determine whether smoking increases the risk of developing a mental disorder or having a mental disorder increases the risk of smoking. People with mental health disorders may view smoking as a coping mechanism for some of the side effects of their mental illness.
Promoting smoking cessation has historically not been seen as a priority by mental health workers, despite the potential consequences of smoking for a patient’s physical health. A ‘smoking culture’ therefore developed around many mental health settings, with smoking not being challenged by staff for a wide variety of reasons. Nevertheless, we know that smokers with mental disorders are just as likely to want to quit as those without.