High rates of smoking among people with serious mental health conditions
From today for the first time, local authorities across England will be able to see the shockingly high rates of smoking among people with serious mental illness compared to the general population in their areas. In some parts of the country more than half of people with a serious mental illness smoke – nearly three times the rate of the general population. 
The Local Tobacco Profiles, managed by Public Health England, show a range of indicators on tobacco use including by socio-economic group, rates of smoking among pregnant women, and smoking attributable hospital admissions. Now, in addition, Public Health England has mapped smoking prevalence by serious mental illness to the local profiles.
In England as a whole, 40.5% of adults with a serious mental illness are smokers which is more than twice the rate of the general population (16.9%). Rates vary across the country and in some local authorities smoking rates among people with serious mental illness are over 50%. These include: Kingston-upon-Hull (52.3%), Southampton (51.3%) and Manchester (51.1%). Some of the lowest rates can be found in Harrow (27.2%), Redbridge (30.4%) and Barnet (30.8%) although even here the rates are nearly twice as high as the average adult population.
Although smoking in the general population has declined steadily since the 1970’s it has remained stubbornly high among those with mental health conditions. 
People with mental health conditions are just as likely as the general population to want to quit smoking but are not getting the support they need. A report published by ASH earlier this year set out recommendations for how smoking rates could be dramatically reduced over the next few years. 
Deborah Arnott, Chief Executive of ASH said:
“These figures show that we need urgent action to help reduce smoking rates among people who have a serious mental illness, who die on average 10-20 years earlier than those without. This appalling gap in life-expectancy is unacceptable and we need the health and social care system to work together to end this inequality.”
Paul Burstow, Chair of the Tavistock and Portman Mental Health Trust said:
“For too long there has been an assumption that smoking among people with a mental health illness is either inevitable or intractable but it is not. We need to challenge these myths and ensure all health professionals are given appropriate training to support people with mental health conditions to stop smoking.”
Ann McNeill, Professor of Tobacco Addiction at King’s College London said:
“Monitoring the rate of smoking among people with a serious mental illness is an important step towards understanding the relationship between smoking and mental health and identifying the barriers this population face to quitting smoking. But local authorities and the NHS must do more to provide the support needed by smokers with mental health illnesses to quit this deadly addiction.”
Notes and Links:
Original data from the HSCIC: Smoking rates in people with serious mental illness. (By Clinical Commissioning Group) (Dataset 1.23)
 Smoking and Mental Health. A joint report by the Royal College of Physicians and the Royal College of Psychiatrists, 2013
 The Stolen Years. The mental health and smoking action report. ASH, 2016.
The report sets out the urgent action needed to get smoking rates falling in this population. There is no single measure that will achieve this but change is needed in all parts of the health and social care system from national government through to local authorities, the NHS and care providers. Key areas for action are:
- National targets and leadership to drive action across the country
- Strong focus on the skills and training of the workforce
- Availability of evidence-based services alongside peer support for all those who need them
- Better access to the medications that will help people to quit
- Improved understanding that electronic cigarettes provide a less harmful alternative to smoking
- Moving to smokefree mental health settings alongside provision of the right support to smokers
The Smoking and Mental Health Partnership was established following publication of the Stolen Years report (see ref 3 below). Its ambition is to see smoking among people with a mental health condition decline to less than 5% by 2035.
Membership comprises the following: Action on Smoking and Health; Association for Directors of Public Health; Chartered Institute of Environmental Health; College of Occupational Therapy; King’s College London; Mental Health Foundation; National Centre for Smoking Cessation & Training (NCSCT); Rethink Mental Illness; Royal College of Psychiatrists; Mental Health Nurses Association; York Mental Health & Addictions Research Group; Royal College of GPs; Cancer Research UK; Mental Health Providers Forum; National Survivor User Network; Centre for Mental Health; Tobacco Control Collaborating Centre; Groundswell; Healthier Futures; Fresh; Smokefree Yorkshire and Humber.