doc-alert

Anne LandmanPosting Date:  Monday, August 15, 2005
I Am A Psychiatrist at the Hawaii State Hospital.
Company/Source Collection:  R.J. Reynolds
Document Date: 04 Oct 2000
Length: 2 pages
Bates No. 522700931/0932
URL of this Posting: http://tobaccodocuments.org/landman/522700931-0932.html
Document Images: http://legacy.library.ucsf.edu/tid/xsm70d00 
    A staff psychiatrist at the Hawaii State Hospital writes to the R.J.Reynolds
tobacco company to beg for free cigarettes for her schizophrenic patient. The
doctor says her patient becomes violent if he doesn't get his scheduled
cigarette and explains that he cannot afford to buy cigarettes on his own.  The
doctor says, "When he runs out of cigarettes he becomes highly agitated to the
point where he has seriously injured staff and other patients...To be honest, in
these cases, providing [the patient with]a cigarette is generally much more
effective at decreasing agitation than most medications I can provide." 

    This letter provides a brutally honest glimpse of the relationship between
mental illness and nicotine use.  We could not find any response from RJR to
this letter.

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Notes 
Thanks to Jennifer McCarthy.
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  Quotes: 

  October 4, 2000

  Consumer Affairs 
  R.J. Reynolds Tobacco Company 
  P.O. Box 7 Winston-Salem, NC 27102

  Two Whom It May Concern:

  I am a psychiatrist at the Hawaii State Hospital. I'm sure this is an unusual
request to be received from a physician. I am asking your assistance in
providing one of my patients with access to cigarettes.  He has no financial
means to purchase cigarettes while in the hospital and is relying on his case
manager to buy them for him out of her own pocket.  She is not always able to
afford to do this form him.  Whenever he runs out of cigarettes he becomes
highly agitated to the point where he has seriously injured staff and other
patients.  A steady supply of cigarettes assists a great deal in managing this
person's agitation.

  My patient is chronically, mentally ill and has very limited means of support.
In fact, once hospitalized for more than three months, he loses his disability
until after discharge.  Couple this with a lack of family support, he does not
have the finances the live independently or obtain such things as new clothes,
items on hospital recreational outings (such as movie tickets or snacks), or
cigarettes. While there are several community services to which I can refer him
for assistance, tobacco assistance is not one of them.

  This person suffers from chronic Schizophrenia. Over the years, it has been
noted that this type of patient uses tobacco heavily, and mine is no exception. 
Reports in the literature have indicated that smoking can lessen the intensity
of auditory hallucinations as well as decrease overall agitation.  In many
instances, patients become highly agitated if they do not have their scheduled
cigarette, and this agitation can escalate to physical violence. To be honest,
in these cases, providing a cigarette is generally much more effective at
decreasing agitation than most medications I can provide.

  Please consider my request for assistance for this individual. Anything that
you company could contribute would be deeply appreciated. I would be more than
happy to discuss this further with one of your representatives if desired. I may
be reached at the hospital on Monday through Friday, from 8:00 a.m. to 4 p.m.
Hawaii Standard Time...The telephone number is (808) 236-8370. Thank you for
your time and consideration in this matter. Look forward to hearing from you in
the future.

  Respectfully,

  Elizabeth S. Roberson, M.D. 
  Staff Psychiatrist
------------------------------------------------------------
  Company 
  R.J. Reynolds 
  Author 
  Robertson, E.S. 
  Hawaii Dept of Health 
  Hawaii State Hospital 
  Recipient 
  R.J. Reynolds 
  Region 
  United States 
  Hawaii 
  Type 
  CONSUMER LETTER 
  Subject 
  nicotine 
  Mental Health 

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