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 www http://www.cdc.gov/vitalsigns

Adult Smoking

Cigarette smoking is the leading preventable cause 

of disease, disability, and death in the US. Despite 

overall declines in smoking, more people with 

mental illness smoke than people without mental 

illness. Because many people with mental illness 

smoke, many of them will get sick and die early 

from smoking. 

Recent research has shown that, like other 

smokers, adults with mental illness who smoke 

want to quit, can quit, and benefit from proven 

stop-smoking treatments. Some mental health 

providers and facilities have made progress in 

this area, while others are now beginning to 

address tobacco use. The 2006 Surgeon General’s 

Report (available at www.surgeongeneral.gov) 

found that smoke-free policies reduce exposure 

to secondhand smoke and help smokers quit. 

Mental health facilities can benefit by making 

their campuses 100% smoke-free and by making 

stopping tobacco use part of an overall approach 

to treatment and wellness. It is critical that people 

with mental illness get the mental health services 

they need and are able to get help to quit smoking 

to improve their overall health and wellness.

About 3 of every 10 cigarettes (31%) 

smoked by adults are smoked by 

adults with mental illness.

Nearly 1 in 5 adults (or 45.7 

million adults) have some 

form of mental illness.*

1 in 5

More than 1 in 3 adults (36%) with a mental 

illness smoke cigarettes, compared with about 

1 in 5 adults (21%) with no mental illness.

3 in 10

1 in 3

 See page 4

Want to learn more? Visit

Focusing on People with 

Mental Illness

*For this report, mental illness is defined as a diagnosable mental, 

behavioral, or emotional disorder, other than a developmental or 

substance abuse disorder.

February 2013

National Center for Chronic Disease Prevention and Health Promotion 

Office on Smoking and Health
Problem

2

Smoking is much more common 

in adults with mental illness 

than other adults.

Smokers who quit have immediate health 

benefits.

◊ Risk for a heart attack drops sharply just 1 

year after quitting. 

◊ After 2 to 5 years, the chance of stroke can fall 

to about the same as a nonsmoker’s.

◊ Within 5 years of quitting, the chance of 

cancer of the mouth, throat, esophagus, and 

bladder is cut in half.

◊ Ten years after quitting smoking, the risk for 

dying from lung cancer drops by half.

Adults with mental illness who smoke 

want to and are able to quit.

◊ Like other smokers, smokers with mental 

illness are interested in quitting, are able to 

quit, and have a better chance of quitting 

successfully when they have access to proven 

stop-smoking treatments.

◊ With careful monitoring, quitting smoking 

does not interfere with treatments for mental 

illness and can be part of the treatment.

◊ People with mental illness face challenges in 

quitting smoking and may benefit from extra 

help to succeed in quitting. This can include 

more counseling as well as longer use or a 

combination of stop-smoking medicines.

More attention is needed to help people with 

mental illness quit smoking.

◊ Some mental health facilities still allow smoking. 

◊ Some mental health facilities allow smoking as a 

reward for progress. 

◊ Some mental health facilities now provide 

counseling and medicine to help smokers quit.

33%

40%

MEN

0

10

20

30

40

50

60

70

80

90

100

WOMEN

48%

34%

At or above

poverty

Below

poverty

By sex By poverty level

Smoking and mental illness

•	Nicotine has mood-altering effects that put

people with mental illness at higher risk for

cigarette use and nicotine addiction.

•	People with mental illness are more

likely to have stressful living conditions,

be low income, and lack access to

health insurance, health care, and help

quitting. All of these factors make it more

challenging to quit.

•	Evidence shows that there has been direct

tobacco marketing to people with mental

illness and other vulnerable groups of

people.

Source: National Survey on Drug Use and Health, 2009-2011, Adults ages 18 or older

Percent of Adults with Mental Illness Who Smoke
3

10

0

20

30

40

50

Less than 

high school

High school 

graduate

Some 

college

College 

graduate

47%

40% 38%

19%

10

0

20

30

40

50

Ages

18-24

Ages

25-44

Ages

45-64

Ages

65+

42%

41%

34%

13%

By Age

10

0

20

30

40

60

50

55%

40% 38% 34% 32%

21%

By Racial/Ethnic Groups

10

0

20

30

40

50

Midwest South Northeast West

39% 38%

35% 32%

By Region

By Education**

American Indian/

Alaska Native 

(Non-Hispanic)

Other 

(Non-Hispanic)

White 

(Non-Hispanic)

Black 

(Non-Hispanic)

Asian 

(Non-Hispanic)

Hispanic

Smoking Statistics for US Adults 

with Mental Illness

Cigarette Use 

among Adults with 

Any Mental Illness

FL

NY

UT

ID

KS

NC

AR

IN

MI

AK

HI

AZ

CO

NE

MT

WY

LA

AL

WI

NM

ND

SD

IA

TX

MS

SC

OK TN

KY

IL OH

WV MD

DE

NJ

VT

RI

CT

NH

MA

VA

GA

CA

WA

OR

NV

ME

MN

MO

PA

<30% 30-34% 35-39% 40-44% 45%+

Source: National Survey on Drug Use and Health, 2009-2011, Adults ages 18 or older

**Source: National Survey on Drug Use and Health, 2009-2011, Adults ages 25 or older
4

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For more information, please contact 

Telephone: 1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov

Web: www.cdc.gov

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Publication date: 02/05/2013

What Can Be Done

This includes:

◊ Helping states develop action plans to reduce 

smoking by people with mental illness.

◊ Providing funding to promising state and local 

programs that make stop-smoking treatment part 

of mental health treatment and wellness.

◊ Making stop-smoking treatments more available 

to people who want to quit.

◊ Conducting research focused on the health and 

longevity of people with mental illness. 

◊ Providing information to mental health treatment 

facilities on the benefits of tobacco-free campus 

policies (i.e., no use of any tobacco product inside 

the facility or anywhere on its grounds). Several 

states are already putting these policies in place.

More progress can be achieved:

By mental health professionals 

◊ Asking their patients if they use tobacco; if they 

do, helping them quit.

◊ Offering proven quitting treatments, including 

tailored quit assistance, to patients who use 

tobacco.

• Referring patients interested in quitting to 

1-800-QUIT-NOW, www.smokefree.gov, or 

other resources.

• Providing more counseling, support, and

stop-smoking medicines.

◊ Making quitting tobacco part of an overall 

approach to treatment and wellness.

◊ Monitoring and adjusting mental health 

medicines as needed in people trying to quit 

using tobacco.

By mental health facilities

◊ Including quitting treatments as part of mental 

health treatment and wellness.

◊ Stopping practices that encourage tobacco use 

(such as not providing cigarettes to patients and 

not allowing staff to smoke with patients).

◊ Making their entire campus 100% smoke-free 

as noted in the 2006 Surgeon General’s Report 

(available at www.surgeongeneral.gov). Several states 

are already putting these recommendations in place.

By state and community leaders 

◊ Helping mental health and tobacco control 

programs to work together to reduce tobacco use 

among people with mental illness.

◊ Encouraging state mental health and addiction 

agencies to put in place tobacco quitting programs 

and tobacco-free campuses.

◊ Supporting sustained, evidence-based tobacco 

control programs.

By people with mental illness 

◊ Deciding to quit using tobacco right away. The sooner 

they stop, the sooner their bodies can begin to heal, 

and the less likely they are to get sick from tobacco use.

◊ Asking their doctors and mental health treatment 

providers for help to quit.

◊ Calling 1-800-QUIT-NOW for free help quitting 

and going to www.smokefree.gov for a step-by-step 

quit guide.

◊ Avoiding secondhand smoke; making their home 

and vehicles smoke-free.

◊ Supporting friends who are trying to quit.

CS236885-B

Federal agencies and national partners are working to reduce

tobacco use among people with mental illness.