Smoking cessation advice for people with serious mental illness

Abstract

BackgroundPeople with a serious mental illness are more likely to smoke more and to be more dependent smokers than the general population. This may be due to a wide range of factors that could include a common aetiology to both smoking and the illness, self medication, smoking to alleviate adverse effects of medications, boredom in the existing environment, or a combination of these factors. It is important to undertake this review to facilitate improvements in both the health and safety of people with serious mental illness who smoke, and to reduce the overall burden of costs (both financial and health) to the smoker and, eventually, to the taxpayer. ObjectivesTo review the effects of smoking cessation advice for people with serious mental illness. Search methodsWe searched the Cochrane Schizophrenia Group Specialized Trials Register up to 2 April 2015, which is based on regular searches of CENTRAL, BIOSIS, PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, and trial registries. We also undertook unsystematic searches of a sample of the component databases (BNI, CINHAL, EMBASE, MEDLINE, and PsycINFO), up to 2 April 2015, and searched references of all identified studies Selection criteriaWe planned to include all randomised controlled trials (RCTs) that focussed on smoking cessation advice versus standard care or comparing smoking cessation advice with other more focussed methods of delivering care or information. Data collection and analysisThe review authors (PK, AC, and DB) independently screened search results but did not identify any trials that fulfilled the inclusion criteria of this review. Main resultsWe did not identify any RCTs that evaluated advice regarding smoking cessation for people with serious mental illness. The excluded studies illustrate that randomisation of packages of care relevant to smokers with serious mental illness is possible.

Are Electronic Cigarettes an Effective Aid to Smoking Cessation or Reduction Among Vulnerable Groups? A Systematic Review of Quantitative and Qualitative Evidence

“…Mortality among substance misusers who concurrently smoked was four times higher than non-smokers (7) and tobacco-related causes were the leading cause of death among people receiving inpatient substance misuse treatment (8). People with SMI or homelessness have significantly reduced life expectancy, to which high smoking prevalence contributes considerably (9–12). Wilcox estimates more prisoners in the United States of America (USA) die from second hand smoke than are legally executed (13).…”

Implementation of a Quit Smoking Programme in Community Adult Mental Health Services–A Qualitative Study

“…The emergence of the current lack of a joined-up approach as a barrier producing inconsistencies in relation to lack of cessation supports and also in relation to exemptions from tobacco free policies echoed the conclusions of a recent review of qualitative studies which called for cessation to be addressed at all levels (systemic, health provider, and individual) among people with severe mental illness (37). Although there is a lack of evidence relating to the effectiveness of advice for those with serious or severe mental illness (49, 50), the motivational impact of HCP advice, where it did occur, was important. This is not surprising, given prompts from health professionals have been shown to be an important driver in quit attempts among smokers in general (51–53).…”

Effectiveness of the Gold Standard Programme (GSP) for smoking cessation on smokers with and without a severe mental disorder: a Danish cohort study

“… 7 Another review illuminating the effect of specialised advice to smokers with an SMD revealed only one ongoing trial investigating this topic. 26 …”