Assistant Professor Works with Patients with Mental Illness to Create Tailored Tobacco Treatment Program

Posted: November 10, 2016

Assistant Professor Chizimuzo (Zim) Okoli, PhD, MPH, MSN, RN, picked up his first and last cigarette when he was just six years old – a mistake that landed him in the emergency room but inspired his life’s work to study mental illness and substance use among marginalized and underrepresented populations.

Typically, he says, people living with schizophrenia, bipolar disorder and other severe mental illnesses do not have the same access to tobacco treatments derived from evidence-based research. “There are many reasons for that, but I believe it is primarily because of the stigma that comes with their illnesses which has caused them to be neglected,” he says.

Dr. Okoli found that the smoking rate among people with mental illness in the U.S. had virtually stayed the same since the 1950s compared to a decrease in population smoking rates overall – an alarming fact that lit a fire in him to dig deeper and get to the root of the problem. 

“These patients don’t die from schizophrenia or bipolar disorder – they die because of COPD (Chronic Obstructive Pulmonary Disease), cardiovascular disease or cancers primarily related to tobacco use or secondhand smoke exposure,” Dr. Okoli says. “I wanted to bring tobacco treatment to this population because they’ve been severely underserved.”

To combat this issue and better serve this population, he currently works with patients living with schizophrenia at Eastern State Hospital (ESH) to create a tailored tobacco treatment program for people with the same and other mental disorders. In his study, he elicits the experiences of smoking cessation among current and former smokers living with schizophrenia.

“Patients living with schizophrenia often smoke to reduce side effects of their psychotropic medications,” says Dr. Okoli. “But it also allows them to sensory-gate for a short period of time, meaning they are able to concentrate more easily.”

As the Director of Tobacco Treatment Services and Evidence-Based Practice at ESH, Dr. Okoli was steered to the hospital’s PALS (Providing Acceptance, Love & Support) Program that aims to boost patient morale and mood by letting them know that the community cares about them. The program was initiated in July 2015 by ESH nursing staff when they realized only 10 percent of the approximately 2,900 patients ESH takes every year receive visitors.

“Volunteers for PALS provide friendship and support to patients. They spend one-on-one time playing games, reading or simply talking and listening,” says Dr. Okoli. “Afterward, we look at patient, volunteer and staff satisfaction to understand their experiences and identify if the volunteers’ perspective toward patients, particularly stigma, has altered.”

Dr. Okoli also serves as the director of the Tobacco Treatment and Prevention Division of the Tobacco Policy Research Program. In this role, he has addressed secondhand tobacco smoke exposure policy in indoor and outdoor public spaces as well as using biomarkers of tobacco exposure. Dr. Okoli was an integral part of the research team assisting Ellen Hahn, PhD, RN, FAAN, professor and mentor of Dr. Okoli, in the implementation of Lexington’s smoke free law which passed in 2004.

“Dr. Okoli is an exceptional colleague and scientist. His caring and compassion for helping individuals with mental illness quit using tobacco is the driving force for his timely and important research program,” said Dr. Hahn.

Dr. Okoli was living in Qatar when he received his acceptance letter from the University of Kentucky College of Nursing, where he received his BSN, MSN, PhD and MPH. “It was certainly the most welcoming letter I received – it said ‘Congratulations! We’re looking forward to seeing you.’”

Prior to that, he had lived in Nigeria, where he was born, and also Canada, where he completed two postdoctoral research fellowships after studying at UK. His research flourished in Vancouver, where he was involved in opening a clinic for tobacco treatment for people with substance use disorders and mental illness. Now, in 2016, there are 13 of these clinics open in Vancouver.

“Dr. Okoli’s dedication to serving those who need it the most is uplifting and resonates so well with the nursing profession. He has truly found his calling and we are honored to stand alongside him in his endeavors to change the stigma around those with mental illness and substance use disorders,” says Dr. Janie Heath, dean and Warwick Professor of Nursing.