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

描述（由申请人提供）：虽然在过去的几十年里，普通人群的吸烟率大幅下降，但精神疾病患者的吸烟率仍然非常高。例如，各种估计表明，50-90%的严重精神疾病患者吸烟，每年近一半与烟草有关的死亡发生在精神疾病患者中。本研究项目旨在了解基于精神健康和戒烟社区之间合作努力的伙伴关系的发展和出现，以解决精神疾病患者的高吸烟率以及由此导致的这一群体存在的健康差异。在本论文的研究中，将探讨以下问题：心理健康和戒烟社区之间的伙伴关系在多大程度上符合社会运动的定义？谁是汇集精神卫生和戒烟社区的关键行为者？这些行为者采用了什么战略？为什么精神卫生界在历史上忽视了精神疾病患者的高吸烟率，这对当前的公共卫生努力有什么影响？伙伴关系的努力对卫生政策和公共卫生的影响是什么？这些问题将通过定性混合方法进行探讨，包括：(1)对全国25位戒烟和心理健康专家进行个人面对面和电话访谈，(2)对心理健康消费者进行5次焦点小组访谈，(3)参与者观察和实地调查，(4)对最近在6家美国主要报纸上发表的有关该主题的文章进行文本分析，数据将使用扎根理论进行分析。这些数据来源将在三个社会学理论视角的背景下被理解：(1)社会问题文献的社会建构，强调精神疾病患者吸烟的社会问题是如何被认识、识别和界定的；(2)社会运动理论，检验合作伙伴的努力是否构成社会运动，以及这类文献如何帮助理解合作伙伴迄今为止的进展及其努力的潜在结果；(3)政治经济学理论，研究政治和经济结构如何塑造精神疾病患者的经历，以及伙伴关系在努力实现其最终目标时可能遇到的优势和挑战。本研究的长期目标是了解精神健康和戒烟社区之间的合作努力如何有效和敏感地降低精神疾病患者的吸烟率，以减少烟草相关疾病，提高生活质量，寿命和康复的可能性。该项目旨在满足疾病控制和预防中心的健康保护目标，即健康人群在生命的每个阶段，重点关注精神疾病患者的戒烟工作，因为这一人群因烟草使用率高而经历了重大的健康差异。

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.