Note from the Editor

CrossCurrents

It’s an indisputable fact that tobacco use causes death and disease, but what isn’t common knowledge is the extent to which it affects the lives of people with mental illness and substance use issues – a population with a higher than average rate of tobacco use. In fact it is tobacco – a legal substance – that is the primary cause of death among people with mental illness or addiction to other substances, many of them illegal. This issue of CrossCurrents explores clinical, ethical and policy issues around tobacco use.

We begin the issue with a story that challenges the long-held assumption that substance use issues are best dealt with one at a time. The story presents a compelling argument for better integrating smoking cessation into addiction services. Anne Ptasznik’s story on smoking and schizophrenia examines other long-standing assumptions about the smoking–schizophrenia connection and challenges clinicians to work with clients with severe mental illness to reduce the number one killer in this population. In a related story, Avril Roberts delves into the smoking ban debate, which pits client rights against client health. We also examine women-centred approaches to smoking cessation among pregnant women and new mothers, extending the scope of interventions to women’s partners. The Q&A examines the harm reduction debate around smokeless tobacco products. Ylva Van Buuren discusses traditional tobacco use among First Nations communities and its implications for clinicians. Finally, in the Last Word column, Dr. Michael Perley of the Ontario Medical Association challenges us to consider why the provincial and federal governments continue to allow the illegal and dangerous contraband tobacco business in First Nations communities.

Enjoy this stimulating issue of CrossCurrents. As always, send us your comments and ideas to keep the dialogue going.

 

Hema Zbogar
tel 416 595­6714
hema_zbogar@camh.net

 

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