UMDNJ-Robert Wood Johnson Medical School Physician
Advocates for Eliminating Tobacco Use in Mental Health Facilities

-- Commentary in Journal of American Medical Association --

New Brunswick, NJ – “The United States public mental health system must address the issue of tobacco use in psychiatric hospitals,” urges Jill Williams, MD, associate professor of psychiatry at UMDNJ-Robert Wood Johnson Medical School and at UMDNJ-School of Public Health, in the February 6 issue of the Journal of the American Medical Association. In the commentary, Dr. Williams implores mental health advocates to support a move toward tobacco-free hospital policies to create a healthy environment and improved behavioral outcomes for patients.

 “Programs that treat behavioral health problems such as depression or schizophrenia are the only remaining sector of health care that fail to systematically help patients quit smoking,” Dr. Williams says.

In her commentary, Dr. Williams cites evidence of poor cardiovascular health and death in mental health patients that is on average 25 years earlier than the general population.  In addition to improving the patient’s physical health, tobacco dependence treatment further supports a patient’s success toward full mental recovery. Dr. Williams emphasizes that mental health advocates must demand increased access to tobacco dependence treatment, to ensure that patients receive safe alternatives to nicotine withdrawal.

Other advantages of eliminating tobacco use are fewer behavioral problems and less violence. Dr. Williams recognizes that opposition to eliminating tobacco use may result from fear of additional behavioral concerns in patients. However, she notes evidence to the contrary, reporting that faculty and staff in tobacco-free facilities actually spend less time in the bartering and control of tobacco products, thereby reducing incidents of conflict and consequently, providing additional and more effective treatment time.

Dr. Williams also points to the additional stigma smoking causes mental health patients, who are already ostracized from general society due to their illnesses. “Stigma is a resonating issue as the mental health community collectively and individually strives for greater community acceptance and integrations of individuals with mental illnesses,” says Dr. Williams. “Advocacy that aims to protect smoking can further marginalize and stigmatize smokers with mental illness who are looking to succeed in securing housing and employment.”

 Ultimately, eliminating tobacco use is in line with national trends that call for mental health care to be more oriented toward wellness and recovery. Dr. Williams concludes, “Patients with mental illnesses deserve the same protection from tobacco exposure that benefits the rest of the public.”

Dr. Williams, of Clinton, NJ, serves as the director of the division of Addiction Psychiatry and director of Mental Health Tobacco Services at the UMDNJ-Robert Wood Johnson Medical School. She also is affiliated with the UMDNJ-School of Public Health Tobacco Dependence Program in New Brunswick and a member of the Cancer Institute of New Jersey.  She is a consultant to the New Jersey State Psychiatric Hospitals on Addressing Tobacco, which is funded by the New Jersey Division of Mental Health Services through UMDNJ-University Behavioral Healthcare.

Dr. Williams conducts research on smokers with serious mental illnesses including schizophrenia and bipolar disorder. Her research examines differences in nicotine intake, cigarette puffing and nicotine craving in individuals with schizophrenia in hopes that these discoveries will lead to better treatments in the future. She has received research funding from the National Institute of Drug Abuse (NIDA), the National Institute of Mental Health (NIMH) and the American Legacy Foundation.

 To interview Dr. Jill Williams, contact Jennifer Forbes at (732) 235-6356.