Not Yet Kicked: The Consequences of Big Tobacco's Targeting of Mentally Ill People

Talk about crazy: Even after the tobacco industry was cornered into revealing in 2007 that it had targeted mentally ill people for decades with fake science and free cigarettes, the puffing continued apace.

Some things did change. Shrinks rarely hand out cigarettes any more as a reward for good behavior, and psych wards are now solidly smoke-free (except in a few holdouts). But mentally ill adults still smoke one third of all cigarettes in the US—schizophrenics* many more than their share—and there’s no simple reason why.

“The effects [of the targeting] are longstanding,” says Stanford psychologist Judith Prochaska, the researcher who dug up the offending industry documents in 2007, unveiling campaigns first devised in the 1950s and enduring all the way through the 1990s.

Two big lies—that smoking relieves the symptoms of psychosis, depression and anxiety and that mentally ill people have a special immunity to tobacco-related diseases—were propagated so aggressively by cigarette-makers that plenty of people still believe them, says Prochaska: “It continues in the culture and in the mental health field.”

Capitalist greed is not quite enough to explain why these particular people keep lighting up, however. Cigarettes do offer a little something special to the mentally ill—and their families and doctors too.

For starters, there’s still nothing quite like a smoke to incentivize a tobacco-addicted inpatient into showing up for an appointment, for instance, or taking his or her medicine on time. A brief visit to the sidewalk will often do it.

And while the clinicians and researchers interviewed for this article all complained about a shortage of funding and training for mental illness-focused cessation programs, they also blamed family members’ objections that “Smoking is all they have!”


I’m just hoping that ecigs are indeed safer. I go through a lot of eliquid a day. 33% of smokers being mentally ill is a huge number. Makes you wonder which came first, the smoker or the mental illness.

Funnily enough I have never smoked. I think an episode at prep school put me off. At the last meal in my last term at prep school another pupil decided to put tobacco in my cup of tea. Not knowing I gulped down the tea and the tobacco. I was then violently sick at the the final assembly.
The thought that tobacco could make me sick like that put me off trying smoking when I was older.
My mother smoked. My brother smokes. My sister smoked, gave up and then went back to smoking again. My father is one of those who’ll very occasionally have a cigarette if offered but is not a regular smoker.

A lot of the patients when I was in hospital smoked. Some were so addicted and also short of money for cigarettes(you didn’t get much money then as an inpatient) that they would gather dog ends especially of cigarettes made with rolling tobacco ,prise out the contents until they had enough to make a roll up and smoke that.

I have to wonder if the doctors were duped by the advertising of nicotine being “helpful” for psychotic symptoms too. Several pdocs I’ve encountered have reinforced the idea that smoking helps ease mental illness in general.

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When I was in a long term mental hospital in the 60’s and 70’s, the common procedure was to distribute cigarettes to any and all patients on the ward. I got heavily addicted as a result and didn’t quit until my 68th year. I really gave nicotine a run for its money, smoking four packs of Pall Malls a day, spending huge amounts of money on them, and indulging myself deeply and thoroughly, leaving no nicotine stone unturned. I also had a big fantasy world based on smoking cigarettes-the cigarettes were my fingers, my ■■■■■, my teeth, or my bones. The smoke was semen, etc., etc. etc. I sometimes tried to prove that these fantasies were true. Give a SZ anything and watch what he makes of it…
Don’t laugh. It happened to me…