Mental health disorders as barries to quit for asthmatic smokers

Abstract

Smoking worsens all asthma parameters. Smokers with psychiatric comorbidities show high nicotine addiction and difficulty to quit. However, the possible interaction between asthma and mental health conditions and its potential impact on quitting behavior on smokers with such commorbidity has not gained research interest.

We examined 2.542.732 patients record which are part of the Whole Systems Integrated Care database (WSIC) in North West London. This is a comprehensive data set in the UK, containing linked coded data from primary care, secondary care, community, mental health and social care across a population of over 2.5 million. We evaluated asthma patient characteristics that are not well studied such as the co-occurrence of sleep disorders, schizophrenia, depression and anxiety and its effects on continuing smoking.

76.224 (3%) pts had asthma. Of these, 6.003 (7.88%) were also suffering from depression, 8.679 (11.4%) from anxiety, 753 (1%) from schizophrenia and 2.764(3.6%) from sleep disorders;revealing asthma the most frequent comorbity (CVD,DM,COPD) of mental health pts. Of note pts with mental health difficulties continued to smoke. Namely 2.787 (46.4%) pts with depression, 3.325(38.3%) with anxiety, 414 (55%) with schizophrenia and 1.091 (39.5%) with sleep disorders were asthmatic smokers. We found that the triple of smoking,asthma and mental health disorders spikes NHS resources consumptions (hospital & social care, A&E and GP visits).

Tailored smoking cessation programs should be offered to asthmatic smokers. The contribution of anxiety, depression and schizophrenia as barriers to quitting, adherence to treatment and exacerbation prevention should be taken into account and form part of the management plan.