Spectator columnist, Andrew Dreschel, and city councillor, Sam Merulla, are both correct when they say that the proposed ban on smoking in subsidized housing is discriminatory against those who are poor. But, it is also an attack on those with serious mental illness, many of whom are also very low income and who need their nicotine for therapeutic reasons.
It has been estimated that about 80% of people with schizophrenia smoke. And, when you ask why, most will tell you that it helps them to relieve the symptoms of the disease not completely controlled by existing medications. They will also tell you that it helps them to think more clearly.
Smoking is so important to the well being of people with schizophrenia that, at one time, psychiatric hospitals provided cigarettes to patients for free. For years after they stopped giving out free smokes, psychiatric hospitals and psychiatric units in general hospitals all had special smoking rooms for these patients. That, of course, has been stopped thanks to the new anti-smoking laws which ignore the needs of those with psychiatric diseases.
In an editorial in the Jacksonville, Florida Observer newspaper this May on a similar topic, Doug Adkins, the director of a program for the mentally ill, commented that the calming effect of nicotine for those with serious mental illness is so well known that many police use it to calm those with psychiatric problems.
There is recent scientific evidence to suggest that the cholinergic system in the brain is also involved with schizophrenia (among a number of others). This is the same system implicated in Alzheimer's Disease and the cause of memory loss for people with Alzheimer's. The most common drugs used for Alzheimer's work on this system to help slow that memory loss. This cholinergic brain system contains nicotinic receptors which exert an effect on cognitive functioning, learning and memory. These receptors are stimulated by the nicotine in cigarettes and help to improve cognitive functioning and the other elements that nicotinic receptors influence.
If the health department in Hamilton wants to help reduce smoking amongst those suffering with psychiatric diseases, they and the health care system should investigate the use of other means of providing therapeutic nicotine to this population as part of their treatment. Forbidding these people to smoke in their own homes if they live in subsidized units or if they are in hospital is cruel and discriminatory.
The patch is one such method to provide nicotine but there are others. Swedish snus is being investigated by health researchers as a substitute. It is an air dried tobacco that is placed under the tongue. Because it is not inhaled, it does not effect the lungs and, because it is not fire-cured, it contains low levels of carcinogens. Electronic cigarettes are another option that should be investigated as another alternative. They deliver nicotine without involving tobacco, smoke or combustion. It has the added feature of being like a cigarette so that the use of hands and placing of a cigarette in the mouth that so many with this addiction need remains.
There are alternatives to helping people with their addiction to nicotine (said to be even more addictive than heroin) than Draconian legislation that is being proposed by the City Health Department and that have been promulgated by the McGuinty Government smoking bans. Governments should be providing these substitutes to people for free.
Marvin Ross is a Dundas medical writer and the author of a book “Schizophrenia: Medicine's Mystery – Society's Shame”. He is also working on a documentary on schizophrenia with Hamilton psychiatrist and film director, David Laing Dawson.
