Tobacco Free for Recovery: Reducing Smoking Among People with Mental Illness

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DESCRIPTION (provided by applicant): While the rates of smoking in the general population have declined substantially over the last decades, the prevalence of smoking among people with mental illness is still extremely high. For example, various estimates suggest that 50-90% of people with serious mental illness smoke, and nearly half of tobacco-related deaths each year occur among people with mental illness. This research project is an attempt to understand the development and emergence of a partnership based on collaborative efforts between the mental health and smoking cessation communities to address the high rates of smoking among people with mental illness and the resulting health disparities that exist for this group. In this dissertation research, the following questions will be explored: To what extent does the partnership between the mental health and smoking cessation communities fit the definition of a social movement? Who are the key actors in bringing together the mental health and smoking cessation communities and what strategies are utilized by these actors? Why did the mental health community historically overlook the high rates of smoking among people with mental illness and what are the implications for current public health efforts? What are the health policy and public health implications of the partnership's efforts? These questions will be explored through qualitative mixed methods approaches including (1) individual in-person and telephone interviews with 25 smoking cessation and mental health experts nationally, (2) 5 focus group interviews with mental health consumers, (3) participant observation and fieldwork, and (4) textual analysis of recently published articles on this topic in 6 leading U.S. newspapers, and data will be analyzed using grounded theory. These sources of data will be understood within the context of three sociological theoretical perspectives: (1) the social construction of social problems literature to highlight the ways in which the social problem of smoking among people with mental illness is recognized, identified, and framed, (2) social movements theories to examine whether the partnership's efforts constitute a social movement and in what ways this body of literature can help to understand the partnership's progress so far and the potential outcomes of its efforts, and (3) political economy theories to study the ways in which political and economic structures shape the experiences of people with mental illness and the strengths and challenges the partnership may encounter in working to achieve its ultimate aims. The long-term goal of this research is to understand how collaborative efforts between the mental health and smoking cessation communities can effectively and sensitively lower the rates of smoking among people with mental illness to reduce tobacco-related diseases and increase the quality of life, number of years of life, and possibilities for recovery. This project aims to meet the Centers for Disease Control and Prevention's Health Protection Goal of Healthy People in Every Stage of Life in that it focuses on smoking cessation efforts for a people with mental illness as this population experiences significant health disparities resulting from high rates of tobacco use.