Smoking by people with mental illness and benefits of smoke-free mental health services

Campion, Jonathan; Checinski, Ken; Nurse, Jo; McNeill, Ann

doi:10.1192/apt.bp.108.005710

Cited by 71 publications

(74 citation statements)

References 91 publications

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“…Smoking rates are markedly higher among individuals with mental health disorders than in the general population, and while smoking rates have fallen over recent decades, corresponding decreases have not been seen in mental health populations1. In particular, smoking is strongly associated with psychotic disorders such as schizophrenia2.…”

mentioning

confidence: 99%

Investigating causality in associations between smoking initiation and schizophrenia using Mendelian randomization

Gage

Jones

Taylor

et al. 2017

Sci Rep

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Smoking is strongly associated with schizophrenia. Although it has been widely assumed that this reflects self-medication, recent studies suggest that smoking may be a risk factor for schizophrenia. We performed two-sample bi-directional Mendelian randomization using summary level genomewide association data from the Tobacco And Genetics Consortium and Psychiatric Genomics Consortium. Variants associated with smoking initiation and schizophrenia were combined using an inverse-variance weighted fixed-effects approach. We found evidence consistent with a causal effect of smoking initiation on schizophrenia risk (OR 1.73, 95% CI 1.30–2.25, p < 0.001). However, after relaxing the p-value threshold to include variants from more than one gene and minimize the potential impact of pleiotropy, the association was attenuated (OR 1.03, 95% CI 0.97–1.09, p = 0.32). There was little evidence in support of a causal effect of schizophrenia on smoking initiation (OR 1.01, 95% CI 0.98–1.04, p = 0.32). MR Egger regression sensitivity analysis indicated no evidence for pleiotropy in the effect of schizophrenia on smoking initiation (intercept OR 1.01, 95% CI 0.99–1.02, p = 0.49). Our findings provide little evidence of a causal association between smoking initiation and schizophrenia, in either direction. However, we cannot rule out a causal effect of smoking on schizophrenia related to heavier, lifetime exposure, rather than initiation.

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confidence: 99%

Investigating causality in associations between smoking initiation and schizophrenia using Mendelian randomization

Gage

Jones

Taylor

et al. 2017

Sci Rep

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“…Smoking lowers energy and fitness levels that restrict mobility and may worsen psychological problems. 8,9 This increased support affects the Psychiatric Disability Rehabilitation and Support Service (PDRSS) sector. The PDRSS sector is well-placed to address smoking cessation, yet little is known about interest in quitting within this context.…”

mentioning

confidence: 99%

Cigarette smoking and interest in quitting among consumers at a Psychiatric Disability Rehabilitation and Support Service in Victoria

Moeller‐Saxone¹

2008

Australian and New Zealand Journal of Public Health

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“…39,40 While some forensic patients objected to the smoke-free policy, for many this presented an opportunity they had not had in any other environment. That is, when given the opportunity and supported to do so, patients were interested in quitting and could quit without adverse impacts on their mental health.…”

Section: Myth 1: Forensic Patients Who Smoke Do Not Want To Quit or Cmentioning

confidence: 99%

Evaluation of a totally smoke-free forensic psychiatry in-patient facility: practice and policy implications

Lawn

Hehir²,

Indig

et al. 2014

Aust. Health Review

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Abstract:Objective: To evaluate the impact of implementing smoke-free policy in an Australian high security forensic psychiatry inpatient hospital.Methods: Focus groups (N=21) and surveys with patients (N=45) and surveys with staff (N=111, 53.2% nurses) elicited their experience and attitudes towards smoke-free policy. A follow-up survey elicited the impact of the policy on 15 patients' smoking practice post discharge.Results: Eighty-five percent of patients stated it was easier quitting when no-one else smoked. Over half of discharged patients surveyed (58%) continued to not smoke postdischarge, despite almost half of staff (41%) perceiving that patients were unlikely to quit long-term. Smoking staff were significantly more pessimistic than non-smoking staff. Many patients (69%) perceived that their health had improved as a result of not smoking. Most staff (80%) viewed nicotine dependence treatment as important, but fewer (66%) felt confident to support patients to stop smoking. Increased patient violence and management difficulties expected by staff were not realized.Conclusions: Smoke-free policy can be successfully implemented in forensic psychiatry inpatient units. Nursing staff are a large and important group who need particular support to implement smoke-free policy into practice effectively, particularly those who are smokers.Continuity of care as part of a coordinated policy and service response is needed.

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Smoking by people with mental illness and benefits of smoke-free mental health services

Cited by 71 publications

References 91 publications

Investigating causality in associations between smoking initiation and schizophrenia using Mendelian randomization

Investigating causality in associations between smoking initiation and schizophrenia using Mendelian randomization

Cigarette smoking and interest in quitting among consumers at a Psychiatric Disability Rehabilitation and Support Service in Victoria

Evaluation of a totally smoke-free forensic psychiatry in-patient facility: practice and policy implications

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