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decline in tobacco use among those with substance abuse issues and depression signals 'public health success story'

the researchers say the results show the importance of health-care providers treating the whole patient — not just the depression or substance abuse disorder.

why has tobacco use dropped among those with substance abuse issues?
cigarette smoke is the leading preventable cause of disease, disability, and death in the united states, the researchers say. getty/istock
there has been a substantial drop in the consumption of cigarettes in the united states among depressed adults and those with substance abuse issues. between 2006 and 2019, the number of smokers with depression fell by 13.1 per cent, according to researchers from the national institute on drug abuse. 
the study, published in the journal of the american medical association, was based on the results of u.s. national surveys on drug use and health over the 13-year period. of the 558,960 adult participants, 53 per cent women, 41 per cent were between the ages of 18 and 25, and 62 per cent were white.
“this study shows us that, at a population-level, reductions in tobacco use are achievable for people with psychiatric conditions, and smoking cessation should be prioritized along with treatments for substance use, depression, and other mental health disorders for people who experience them,”  nora volkow, co-author of the study, said in a statement. “therapies to help people stop smoking are safe, effective, and may even enhance the long-term success of concurrent treatments for more severe mental health symptoms in individuals with psychiatric disorders by lowering stress, anxiety, depression, and by improving overall mood and quality of life.” 
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cigarette smoke is the leading preventable cause of disease, disability, and death in the united states, the researchers say, but the number of conditions and fatalities has been going down thanks to better education and smoke-free policies. 
in canada as of 2017, approximately 4.6 million adults, or 15.1 per cent of the population at the time, were smokers according to the university of waterloo. that’s a decrease of 10 per cent from 1999. 

smoking is the leading cause of disease, disability and death

an estimated one-quarter of canadians has some degree of depression serious enough to seek help in their lifetimes, according to the ontario government. additionally, about 21 per cent of canadians, or six million people, will experience some form of substance use disorder in their lifetimes, rehabilitation clinic calgary dream centre says. 
past-month cigarette usage, essentially meaning someone who has smoked in the last month, fell by 10.9 per cent for those with substance use disorders, and 13.7 per cent for those with major depression and substance use disorders. for those without these conditions, the number fell by 7.6 per cent in the same period. 
“these declines tell a public health success story,” wilson compton, senior author of the study, said. “however, there’s still a lot of work to be done to ensure tobacco use in patients with substance use disorder, depression, or other psychiatric conditions continue to decrease.”
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he also noted the importance of health-care providers treating the whole patient — not just the depression or substance abuse disorder.
“to do this,” he says, “smoking cessation therapies need to be integrated into existing behavioural health treatments. the result will be longer and healthier lives for all people.” 
the scientists noted that the smoking rates did not decline among non-hispanic american indian or alaska native adults, and that these populations face the highest smoking rates in the country, as well as the lowest quitting rates. 
going forward, researchers say they need to include data on certain populations who may be higher risk for psychiatric disorders and smoking, including homeless, or institutionalized people. they also plan to look into use of vapes, and substance abuse during the covid-19 pandemic. 
chris arnold is a toronto-based writer.
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