Objective: Global tobacco control efforts in both prevention and treatment have
advanced to levels never imagined 20 years ago. This review examines the
relationship between mental illness and tobacco use, with particular focus on the
role of psychiatrists in the treatment of tobacco dependence. Methods: The
literature search utilised MEDLINE, Embase and PsychINFO databases using
the terms psychiatry, psychiatrist, smoking cessation, tobacco use disorder and
tobacco dependence treatment. A manual search of all references from relevant
scientific articles obtained was also conducted. Finally, further material sourced
included all major guidelines for smoking cessation or tobacco dependence
treatment from the United States, United Kingdom, Canada, Australia and New
Zealand. Results: Psychiatry has ignored tobacco dependence and its treatment
resulting in multiple missed opportunities in improving the health and well-being
of smokers with mental illness. Improvement in the training and knowledge of
psychiatrists and those in the mental health sector will be the most effective
activity to rectify this situation. Conclusion: Psychiatry must recognise tobacco
dependence as equally important as the primary mental illness and to treat
accordingly. A significant change in the training of future psychiatrists,
introducing or implementing smoke free mental health services, changes in the
management of caring for the mentally ill, and the introduction of tobacco
treatment specialists within the mental health system is needed if psychiatry is
serious about confronting this problem.