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Gary Tedeschi, PhD

Gary has been Clinical Director of the California Smokers' Helpline since 1994. A licensed psychologist, Gary is responsible for clinical supervision, counseling protocol development, counselor training, and continuing education. He also serves as teaching faculty for the Center for Tobacco Cessation, focusing on the elements of effective behavioral interventions to help smokers quit.

Recent Posts

Common Myths about Smoking and Behavioral Health

Posted by Gary Tedeschi, PhD

May 9, 2017 12:02:13 PM

Older Man_Web.jpgMay is Mental Health Month and a good time to revisit some of the common myths about smoking and behavioral health.

People with behavioral health conditions (mental illness and substance use disorders) smoke at higher rates than those without behavioral health conditions.  Alarmingly, people with mental illness and substance used disorders are dying up to 25 years earlier than the general population. The major causes of death are often smoking related cancer, heart disease, and lung disease.1,2

Unfortunately, there are still misconceptions that smokers with behavioral health conditions are not interested in smoking cessation and lack the ability to quit.  There are also concerns that these smokers will experience increased psychiatric symptoms when they quit.3 As a result, providers may not include smoking cessation in their treatment plans.  Instead, they focus primarily on behavioral health symptom management.

The reality is that people with mental illness and substance use disorders want to quit smoking and can quit successfully. Health care professionals can play an essential role in this process. Providers can bolster a broad health and wellness philosophy for patients by seeing tobacco cessation as a key component of behavioral health treatment and recovery.

Myths and Facts About Smokers with Behavioral Health Conditions

Here are some common myths and facts about smokers with behavioral health conditions.

Myth #1: Persons with mental illness and substance use disorders don’t want to quit.

Fact: The majority of persons with mental illness and substance use disorders want to quit smoking and want information on cessation services and resources.

Several research studies indicate that the majority of persons with behavioral health conditions want to quit smoking and want information on cessation services and resources. 4, 5, 6 

Myth #2:  Persons with mental illness and substance use disorders can’t quit smoking.

Fact:  Persons with mental illness and substance use disorders can successfully quit using tobacco.

There is a growing body of literature indicating that this clientele can quit.  For example, results from a large, internationally run randomized controlled trial showed that smokers with behavioral health conditions can quit successfully using nicotine patches, Zyban, or Chantix, compared to placebo, with no significant increase in neuropsychiatric adverse events.7

Myth #3:  Smoking cessation worsens psychiatric symptoms.

Fact:  Smoking cessation can improve psychiatric symptoms.

This myth has historical ties to the tobacco industry, which directly funded, or monitored, research supporting the idea that individuals with behavioral health conditions (schizophrenia in particular) were less susceptible to the harms of tobacco and that they needed tobacco as self-medication.  Fortunately, research has been emerging to debunk this myth.8,9

Myth #4:  Smoking cessation will threaten recovery for persons with substance use disorders.

Fact:  Smoking cessation can enhance long-term recovery for persons with substance use disorders.10

Research has shown that smoking cessation can encourage and support recovery.  For example, a systematic review of 17 studies found that concurrent tobacco cessation treatment with individuals in addictions treatment was associated with 25% increased abstinence from alcohol and illicit drugs six months or longer after treatment. 6

Increasingly, these myths about smoking and behavioral health are giving way to the facts. This is important for a clientele who will benefit greatly from an integrated treatment approach that includes smoking cessation as a priority focus.

For More Information

For more information about smoking and behavioral health, please visit our website or explore our free CE Courses on a variety of smoking and behavioral health issues.

1 Colton, C. W. & Manderscheid, R. W. (2006). Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease, 3(2).

2 Walker, E. R., McGee, R. E., & Druss, B. G. (2015). Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA psychiatry, 72(4), 334-341.

3 Prochaska, J. J. (2010). Failure to treat tobacco use in mental health and addiction treatment settings: A form of harm reduction? Drug and Alcohol Dependence, 110(3), 177- 182.

4 Prochaska, J. J., Rossi, J. S., Redding, C. A., Rosen, A. B., Tsoh, J. Y., Humfleet, G. L., . . . Hall, S. M. (2004). Depressed smokers and stage of change: Implications for treatment interventions. Drug and Alcohol Dependence, 76(2), 143-151. doi:DOI: 10.1016/j.drugalcdep.2004.04.017

5 Prochaska, J. J.,Reyes, R.S., Schroeder, S.A., Daniels, A. S., Doederlein, A., & Bergeson, B. (2011). An online survey of tobacco use, intentions to quit, and cessation strateies among people living with bipolar disorder. Bipolar Disorders, 13(5-6), 466-473. doi:10.1111/j.1399-5618.2011.00944.x

6 Joseph, A. M., Willenbring, M. L., & Nugent, S. M. (2004). A randomized trial of concurrent versus delayed smoking intervention for patients in alcohol dependence treatment. Journal of Studies on Alcohol, 65(6), 681-691

7 Anthenelli, R. M., Benowitz, N. L., West, R., St Aubin, L., McRae, T., Lawrence, D., ... & Evins, A. E. (2016). Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. The Lancet, 387(10037), 2507-2520.

8 Prochaska, J. J., Hall, S. M., Tsoh, J. Y., Eisendrath, S., Rossi, J. S., Redding, C. A., . . . Gorecki, J. A. (2008). Treating tobacco dependence in clinically depressed smokers: Effect of smoking cessation on mental health functioning. American Journal of Public Health, 98(3), 446-448. doi:10.2105/AJPH.2006.101147

9 Evins, A., Cather, C., Deckersbach, T., Freudenreich, O., Culhane, M., Olm-Shipman, C., . . . Rigotti, N. (2005). A double-blind placebo-controlled trial of bupropion sustained-release for smoking cessation in schizophrenia. Journal of Clinical Psychopharmacology, 25(3), 218-225. doi:10.1097/01.jcp.0000162802.54076.18

10 Prochaska, J. J., Delucchi, K., & Hall, S. M. (2004). A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. Journal of Consulting and Clinical Psychology, 72(6), 1144-1156. doi:10.1037/0022-006X.72.6.1144

Make 2016 Your Year to Quit Smoking

Posted by Gary Tedeschi, PhD

Dec 29, 2015 11:09:53 AM

Quit smoking to start your year off right.

2016-New-Years-Sunset.jpgEvery January 1, people all over the world make New Year's resolutions, according to the Centers for Disease Control. If you're one of the nearly 7 in 10 U.S. smokers who want to quit, why not make a resolution to get started? Smoking is still the number one cause of preventable death and disease in the United States. Quitting now can cut your risk for diseases caused by smoking and leave you feeling stronger and healthier.

Tiffany, a former cigarette smoker, was 16 when her mother—also a smoker—died of lung cancer. Despite her loss, Tiffany started smoking. She finally decided to quit when her daughter Jaelin turned 16 because she could not bear the thought of missing out on any part of Jaelin's life, like her own mother did. Her effort to quit began with setting a specific date to quit smoking and reaching out to family and friends for support. In the video "Tiffany's Decision" from CDC's Tips From Former Smokers (Tips) campaign, she talks about the "aha" moment that sent her on a different, healthier path for her own life.

Most smokers who want to quit try several times before they quit for good. The most important thing is to never give up. There is help available for you to reach your goal of quitting smoking once and for all.

Free, Effective Resources

FemaleHispanicCounselor.jpgThe California Smokers' Helpline offers a variety of free quit smoking resources in English, Spanish, Chinese, Korean, and Vietnamese, proven to double a smokers chance of successfully quitting:

  • Telephone Counseling. One on one support over the phone from a trained, caring counseler who will help you make a quit plan, send you free materials, or refer you to other resources in your area. To get started now, call 1-800-NO-BUTTS (1-800-662-8887) or register online.
  • Texting Program. This free 24/7 texting program sends encouragement, advice, and tips to help you quit smoking for good. Register online to get started.
  • Online Help. A wealth of online tips and resources for quitting smoking are available in English, Spanish, and Asian languages (Chinese, Korean, and Vietnamese).

Quitting Aids

patch.jpgBecause cigarettes contain nicotine, a powerfully addictive drug, when you first quit, your body may feel uncomfortable until it adjusts. This is known as withdrawal, and there are quitting aids that can help lessen this feeling and the urge to smoke.

Studies show that smokers who use quitting aids to help control cravings, along with coaching from a quitline, in a group, or from a counselor, are much more likely to succeed than those who go it alone.

Talk to your doctor, pharmacist, or other health care provider before using any quitting aids if you:

  • Are pregnant or nursing
  • Have a serious medical condition
  • Are currently using other medications
  • Are younger than 18

For More Information

Visit our website or download one of our free fact sheets.

As the start of a new year approaches, isn't now the perfect time to quit smoking? Start off 2016 by taking control of your smoking.  Use the free resources available to you and make a plan to quit for good.  Even if you don't smoke yourself, you can share the information here to help a friend or family member become smokefree in 2016!

Free Smokers' Helpline Services

The 4 Ds and 2 Rs for Dealing with Cravings and Urges

Posted by Gary Tedeschi, PhD

Feb 25, 2015 12:11:00 PM

So, you have quit smoking—congratulations! You have just taken one of the most important steps you can take to protect your health and the health of those around you.

However, you might be experiencing urges to smoke, particularly during the first few days. It’s important to remember that nicotine cravings do not last long--most last only 3 to 5 minutes. As time passes, they get weaker and come less often. You could still have some cravings, but they will just pass by. If you quit Cold Turkey, the nicotine will be out of your body after only 3 days.

Check out these tips from the American Cancer Society for dealing with cravings and urges.

The Four D’s

Try these techniques to get through those cravings:

Delay......................................Wait it out.

Distract yourself.................Do something else.

Deep breathe......................Release tension.

Drink water...........................Satisfy the craving.

For more ideas, click here.

The Two R’s:

And remember the two R’s:

Remind…………..Go over your reasons to quit.

Refuse……………Think: it’s not that you can’t smoke, it’s that you don’t want to smoke.

For More Information

For free, confidential help over the phone to quit smoking or to stay quit, please call the California Smokers’ Helpline at 1-800-NO-BUTTS (1-800-662-8887) or register online for services. For more information, download our free fact sheet:

 Download Fact Sheet Now!


1. American Cancer Society. (2014, February 6). Guide to quitting smoking. Retrieved from http://www.cancer.org/acs/groups/cid/documents/webcontent/002971-pdf.pdsf

About this Blog

The California Smokers' Helpline offers free, evidence-based tobacco cessation services in multiple languages to help smokers quit. We also offer free training and resources to health professionals to increase their knowledge and capacity for tobacco cessation.

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For more information about our free training and resources for health professionals, please contact the Helpline Communications Department at (858) 300-1010 or cshoutreach@ucsd.edu.

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