tupakka ja masennus sekä hoidot (englanniksi)

NCHS has just released a Data Brief showing strong associations between smoking and depression. Their key findings are:

     * Adults aged 20 and over with depression were more likely to be cigarette smokers than those without depression.
     * Women with depression had smoking rates similar to men with depression, while women without depression smoked less than men.
     * The percentage of adults who were smokers increased as depression severity increased.
     * Among adult smokers, those with depression smoked more heavily than those without depression. They were more likely to smoke their first cigarette within 5 minutes of awakening and to smoke more than one pack of cigarettes per day.
     * Adults with depression were less likely to quit smoking than those without depression.

See the full article at:

Drug Alcohol Depend. 2010 Apr 6. [Epub ahead of print] Failure to treat tobacco use in mental health and addiction treatment settings: A form of harm reduction?

Prochaska JJ.

University of California, San Francisco, 401 Parnassus Ave - TRC 0984, San Francisco, CA 94143-0984, USA.

In mental health and addiction treatment settings, failure to treat tobacco dependence has been rationalized by some as a clinical approach to harm reduction. That is, tobacco use is viewed as a less harmful alternative to alcohol or illicit drug use and/or other self-harm behaviors. This paper examines the impact of providers' failure to treat tobacco use on patients' alcohol and illicit drug use and associated high-risk behaviors. The weight of the evidence in the literature
indicates: (1) tobacco use is a leading cause of death in patients with psychiatric illness or addictive disorders; (2) tobacco use is associated with worsened substance abuse treatment outcomes, whereas treatment of tobacco dependence supports long-term sobriety; (3) tobacco use is associated with increased (not decreased) depressive symptoms and suicidal risk behavior; (4) tobacco use adversely impacts psychiatric treatment; (5) tobacco use is a lethal and ineffective long-term coping strategy for managing stress, and (6) treatment of tobacco use does not harm mental health recovery. Failure to treat tobacco dependence in mental health and addiction treatment settings is not consistent with a harm reduction model. In contrast, emerging evidence indicates treatment of tobacco dependence may even improve addiction treatment and mental health outcomes. Providers in mental health and addiction treatment settings have an ethical duty to intervene on patients' tobacco use and provide available evidence-based treatments.