Premature mortality rates among people with an SMI such as bipolar disorder or schizophrenia were 3.7 times higher than the general population in the financial year 2014 to 2015[footnote 10]. This gap has widened in recent years (from 3.3 in the financial year 2009 to 2010)[footnote 10], largely due to increases in the mortality rate in those with an SMI[footnote 10]. Premature mortality rates in people with an SMI were higher than the general population for many of the leading causes of death, including cardiovascular disease, cancer, respiratory disease and liver diseases. In 2014 to 2015, the gap was wider for deaths from respiratory disease and liver disease mortality. The premature mortality rates were 4.7 and 5.0 times greater in those with an SMI respectively[footnote 10]. However, as with the general population, there were more premature deaths among people with SMI from cardiovascular disease and cancer than the other causes[footnote 10]. These findings in part reflect the higher levels of smoking and substance misuse including alcohol[footnote 12] in those with an SMI.