Social workers should be given the tools to promote tobacco harm reduction as they’re often the ‘initial, and in some cases, only’ point of contact with a range of marginalised communities, says a new briefing paper from the Global State of Tobacco Harm Reduction (GSTHR).
Social workers can have a ‘significant influence’ over people’s wellbeing, says the document, with smoking disproportionately affecting the vulnerable and marginalised populations they’re likely to work with. According to WHO statistics, two thirds of people with severe mental health conditions smoke, rising to 70-80 per cent among those experiencing schizophrenia.
Tobacco harm reduction is a ‘potentially life-saving intervention’ for millions of people, the briefing states, enabling them to switch from high-risk products like cigarettes to alternatives like vapes, snus, nicotine pouches and heated tobacco products.
‘People smoke for a variety of reasons even though they know it’s bad for them,’ states GSTHR, which is a project from public health agency Knowledge Action Change (K-A-C). ‘While many experience pleasure from using nicotine, just as people enjoy using caffeine or alcohol, others use it to cope with sadness, boredom or the stresses of their daily lives. For some people with schizophrenia, using nicotine can be a form of self-medication, which they feel allows them to treat cognitive symptoms or reduce the side effects of psychiatric medicines.
‘Social workers around the world regularly work with individuals who are more likely than the general population to smoke, for example people experiencing mental health and substance use issues,’ said K-A-C director David MacKintosh. ‘However, few countries train social workers to support those who want to quit smoking. This is a missed opportunity for both individuals in need and the public health system. Equipping social workers with the tools to provide trusted information and advice on tobacco harm reduction options would benefit their clients, as well as their families and communities. It would save lives. The potential is massive, especially in countries where smoking cessation services are rare, non-existent or expensive to access.’
Earlier this year MacKintosh told DDN how smoking remained an ‘elephant in the room’ for drug and alcohol services – with around half of people in treatment smokers, according to OHID statistics. ‘We know that drug services are an important step in keeping people alive, but the reality for most people is the drug that’s likely to kill them probably isn’t heroin or crack cocaine,’ he said. ‘Fifty per cent of our heroin users will not die from heroin, but 50 per cent of smokers will die because they smoke. So whether it’s smoking cessation or helping people find an alternative, there’s a huge potential win there for the individuals and services.’
Smoking and vulnerable populations: supporting smoking cessation and tobacco harm reduction in social work available here