The Psychiatrized are Smoking


A report from the U.K.’s Royal College of Physicians and Royal College of Psychiatrists finds that while smoking rates in the general population have fallen dramatically, the rate of smoking among those diagnosed with mental health disorders has not: “Smoking is increasingly becoming the domain of the most disadvantaged: the poor, homeless, imprisoned and those with mental disorder.” A Lancet editorial states that “agitation resulting from the absence of cigarettes might be misattributed to mental illness… (the lack of smoking reduction is) reflective less of the neurobiological intricacies of mental illness, and more of the ongoing marginalisation of people with mental illness.”

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Of further interest:
Smoking may be a sign of psychiatric illness, says report, after a third of smokers are found to have a mental disorder (The Independent)

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. Lancet article on smoking among the so-called “mentally ill” misses an essential point. This bogus article, of course, starts by raising genetic issues as the first possible explanation for the high rates of smoking when it uses the phrase “…common gentic pathways may increase the risk.”

    You don’t have to be a genius to know why people on antipsychotic medications might tend to smoke more and also drink alot of caffeinated beverages. WHAT ABOUT THE FACT THAT ANTIPSYCHOTIC DRUGS BLOCK DOPAMINE RECEPTORS IN THE BRAIN. WHAT ABOUT THE FACT THAT THESE DRUGS CAUSE LETHARGY, IMPAIRED THINKING, AND DIFFICULTY FOCUSING AMONG OTHER DAMAGING SIDE EFFECTS.

    It makes perfect sense that under these circumstances that people on these terrible drugs would seek out any substance (Duh!, like nicotine and caffeine) that would boost dopamine levels in the brain to compensate for these imposed deficits in brain chemistry.

    For this to not even be mentioned as a possibility is the height of intellectual and scientific incompetance and another example of Biological Psyhiatry’s desire to hide the truth of their crimes.


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  2. Maybe so in the U.K., but in the U.S., there is no possible way they can afford to smoke. Even the cheapest roll-your-owns cost 4 dollars a pack now.

    I consider this important because there are many people who are blaming cigarette smoking for the 25 year decrease in life expectancy, although I point out to them that cigarettes existed and were popular among’st the mentally ill LONG BEFORE this decrease started.

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    • Jeffery

      People in the community mental health system are still smoking in high numbers. Don’t forget that cigars are not taxed like cigarettes. So the tabacco companies make these small cigars that look exactly like a cigarette (they even have filters on them) and sell them for 2 dollars a pack. Capitalism is a wonderful thing!

      I agree that smoking is used as an excuse by Biological Psychiatry to hide the damaging effects of the psych drugs on life spans.


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  3. Totally agree with Richard, the reasons people smoke is solely about the side effects of the drugs they are forced to take. We also know for instance that it is much higher among those on antipsychotics, than not on them. We also know that nicotine stops much the drug going to the brain and people can need to be on massively reduced doses when not smoking. Blood tests can show how much of the drug is being absorbed by the body and those levels will be dramatically different if the person is not smoking. But try to get a psychiatrist to lower the medication because they quit. Many take it up, solely to deal with side effects. I know one person who stopped when A psychiatrist finally agreed to dramatically lower the dose of the drug that she was on. She was bascially weaned off cigarettes at the same time as the drug.

    I’m in Australia and we have the largest restrictions anywhere in the world on where people can and can’t smoke. One can no longer smoke within 10 metres of a bus stop, within 10 metres of the grounds of the hospital, you cannot smoke in a car that has children under the age of 18 in it, and yes parents are fined thousands of dollars if they are found to be smoking in their own car with their own children. We now have plain labelled packaging on all types of smokes, so labels from the companies are not allowed (they fought it all the way to the full bench of our high court and lost). The only thing on packets is massive pictures of body parts half dead from smoking related causes, and large details of the damage caused. Small print on the top of the packets allows one to know what brand and type of smoke it is. ALL types are taxed at excessively high rates and it is increasing all the time. Those I know who smoke do so by largely not eating, not paying rent, etc. They choose to smoke than having a place to live, food to eat, etc. And they do so in the vast majority of cases to deal with medication side effects. ALL mental health services have massive quit programs in place they are lucky to have anyone successfully quit. People are going to huge lengths to get to cigarettes while in hospital, including offering all sorts of sexual favours on the basis of a smoke. Forced treatment orders are largely not needed they just refuse to give them there smokes if they do not comply, and they will do anything at all. And the simple fact is they NEED the smokes to deal with side effects. Getting rid of the drugs they force on people, which they call medications is the first step, but dramatically lowering the doses would also be a massive step in the right direction and would result in many people able to at least reduce the levels they are smoking at.

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