RESEARCH WEEKLY: Smoking Intensity Increases During COVID-19 for People with Severe Mental Illness
By Kelli South
Inequalities in smoking behaviors between people with severe mental illness and people without continued to increase during the COVID-19 pandemic, according to a new study published in BJ Psych Open. While smoking rates and quantity consumed has historically been unequal between those with severe mental illness and those without, the authors suggest that the COVID-19 pandemic may have further increased these gaps in use and intensity of use.
Smoking inequities continue for people with severe mental illness
The study examined smoking in a study cohort of 367 people with severe mental illness in the United Kingdom between July and December 2020 and the data was primarily based on self-reported behaviors.
The results showed that 27% of the study population, who all have a severe mental illness, smokes compared to 14% of the general population. Those in the study smoke 18 cigarettes per day on average, far higher than the average of nine cigarettes per day for the general population. Furthermore, 55% of people in the study reported smoking within five minutes of waking up, compared to just 7% of the general population who reported the same.
Within the study cohort, 55% reported smoking more heavily since the pandemic began and 12% of the cohort said they had been smoking less during the pandemic. This finding implies that overall those with severe mental illness had more intense smoking habits during the COVID-19 pandemic than they did before the pandemic began.
These results highlight the continued increased tobacco use rates among people with severe mental illness, particularly when compared to the general population. However, the study also found that between the initial data collection period for the survey population that occurred between 2016 and March 2020, smoking rates decreased overall during the pandemic. So, while intensity of use among smokers with severe mental illness increased, there was a net decrease in usage rates during the same time period.
Implications for further investigation
The authors cannot definitively conclude that the decreased rate of use and increased intensity of use were directly caused by the pandemic, but their findings indicate that more research should be conducted in this field to determine the potential effects of the COVID-19 pandemic on smoking behaviors of people with severe mental illness. This is particularly the case for the potentially increased inequities in smoking behaviors between the general population and those with severe mental illness that appear to have occurred during the pandemic.
Smoking is a major health concern for people living with severe mental illness and contributes to the population’s generally worse health outcomes and lower predicted lifespans. If intensity of use increased over the past year, it is important to research this further and implement more smoking cessation programs for those with severe mental illness.
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