The Invisible Dead: Tobacco, Mental Health and Human Rights
Laura Graen 1  
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Laura Graen Human Rights and Tobacco Control, Berlin, Germany
Publication date: 2020-10-22
Tob. Prev. Cessation 2020;6(Supplement):A90
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People with severe mental health disorders are more likely to smoke, often smoke more and die at much higher rates from tobacco-related diseases than the general population. The reasons for this are complex and under-researched.
Due to the character of their diseases and the attached stigmatization, persons with mental health disorders have difficulties to raise their voice and get heard in societal discourses. They are (made) invisible, and as a result, their increased death rates remain disregarded.

Raise awareness of excess mortality among people with mental health disorders. Demonstrate human rights principles.

The presentation uses peer-reviewed literature on the link between tobacco-related diseases and mental health disorders and analyses this information from the perspective of the Convention on the Rights of Persons with Disabilities and other human rights treaties.

There is no systematic data collection about tobacco-related excess mortality among people with severe mental health disorders. However, research estimates that about half of deaths among people affected by schizophrenia, bipolar disorder or depression are caused by tobacco-related diseases. The reasons for this are complex and link to tobacco prevention (tobacco advertising targeting or increased susceptibility), lack of regulatory measures (e.g. smoke-free mental health institutions), cessation (e.g. tobacco dependence seen by health professionals as less urgent compared to other symptoms and therefore not being treated), comorbidities (e.g. alcoholism) as well as delayed diagnosis and treatment of cancer and other diseases.

The above mentioned inequalities ultimately translate to higher morbidity and mortality rates in marginalized groups and a government’s failure to take action to address them is a clear violation of the non-discrimination principle and the human rights to health and life. More has to be done to collect data and to tailor tobacco control policies and cessation programmes to reach people with severe mental health disorders.