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The Stolen Years: The mental health and smoking action report

This report from Action on Smoking and Health is a call to action. It challenges defeatist assumptions that addiction to smoking amongst people with mental health conditions is either inevitable or intractable: it is not.

While smoking rates amongst the general population have fallen dramatically in the past few decades they have remained stubbornly high amongst people with mental health conditions. Seventy percent of those discharged from a psychiatric hospital are smokers. The result is lives cut short and in their final years lives blighted by heart and lung diseases, stroke and cancer. These are the stolen years - of life, of health and of wealth.

There is an urgent need for action to tackle this growing health inequality. A third of all tobacco now smoked in England is by someone with a mental health condition. Yet the desire to quit is just as strong as for the average smoker. These smokers do not lack motivation to quit but are more likely to be highly addicted and heavily dependent on tobacco, and therefore need more help.

When ASH asked smokers with a mental health condition if anyone providing inpatient care had offered them help to stop smoking two thirds told us no one had. Even among those who had been asked, few had been offered real support. Harm can occur not just when something happens, acts of omission cause harm too. For the goal of “parity of esteem” to be meaningful, people with mental health conditions need help to quit smoking.

Change can happen. This report documents what works to help people with mental health conditions quit. But to reverse the trends and return those stolen years leaders and professionals in every part of the health and social care system must act. Reversing decades of inaction requires a social movement across the whole system which hard wires service user and carer voice and experience into a common endeavour to support more people with a mental health condition become smokefree.

This is not a quick fix, nor will it be easy, but without a collective effort we will continue to condemn millions of the most vulnerable people in our society to needless death and disease.