Telephone based smoking cessation intervention for adults with serious mental illness during the COVID-19 pandemic

Leutwyler, Heather; Hubbard, Erin

doi:10.1177/1179173x211065989

Cited by 3 publications

(1 citation statement)

References 13 publications

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“… 17 , 18 Our prior work also showed the importance of in-person support as people with SMI go through the smoking cessation process. 19 We hypothesized that adding a game-based group physical activity program would provide the additional support needed for smoking cessation.…”

Section: Introductionmentioning

confidence: 99%

The Whole Package: A Multi-Component Smoking Cessation Intervention for Adults With Serious Mental Illness: A Qualitative Study

Leutwyler,

Hubbard,

Humfleet

et al. 2024

Tob Use Insights

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Introduction: Smoking is one of the most important modifiable risk factors for excess morbidity and mortality in adults with serious mental illness (SMI). Many smokers with SMI are reportedly motivated to quit, however success rates among these smokers remain low and evidence-based treatment targeting this vulnerable group is limited. The purpose of this paper is to report the results of a qualitative inquiry of participants. Methods: We conducted a pilot two-arm randomized controlled trial (RCT) targeting adults with SMI. Our smoking cessation intervention included: (a) group-based physical activity (PA) game intervention (50 minutes, 3X/week for 12 weeks), (b) pharmacotherapy (bupropion or nicotine replacement therapy), and (c) smoking cessation counseling. Upon completion of the program, participants in the active and control groups completed a qualitative semi-structured interview in order to determine how the program impacted their smoking cessation. Grounded Theory methodology guided our data collection and analysis. Results: Twenty participants completed an interview. Participants described how the “whole package” of the 3 components of the intervention were critical to their smoking cessation process. The group-based program provided the structure, resources, and encouragement needed to start the process of quitting. Conclusion: Adults with SMI need support, resources, and engaging activities as they begin quitting and practice the skills needed to quit.

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Section: Introductionmentioning

confidence: 99%

The Whole Package: A Multi-Component Smoking Cessation Intervention for Adults With Serious Mental Illness: A Qualitative Study

Leutwyler,

Hubbard,

Humfleet

et al. 2024

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Effectiveness and Experience of Implementing Digital Interventions to Promote Smoking Cessation Among Adults With Severe Mental Illness: A Systematic Review and Meta-analysis

Huddlestone,

Shoesmith,

Pervin

et al. 2024

Nicotine and Tobacco Research

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Introduction Digital technology is increasingly used to support interventions targeting smoking cessation in people with severe mental illness (SMI). However, little is known about their implementation and effectiveness in this population. We aimed to determine their effectiveness, stakeholder experiences, factors influencing implementation, and quality of reporting of digital interventions for smoking cessation in adults living with SMI. Method Five online bibliographic databases were searched for articles published between 31 December 2000 and 31 January 2023. Studies involving adults accessing treatment for alcohol and substance use disorders, neurocognitive disorders and terminal illnesses were excluded. Risk of bias was assessed using the Mixed Methods Appraisal Tool (MMAT). A Mantel–Haenszel random-effects meta-analysis of randomized controlled trials (RCTs) was conducted. Participant experience and intervention implementation were explored using a narrative synthesis. Quality of reporting of interventions was assessed using the Template for Intervention Description and Replication (TIDieR) checklist. Results Thirty-one studies enrolling 3,794 participants were included. Meta-analysis of biochemically verified abstinence at longest follow-up (month-1 to month-6) did not find an overall effect in favour of intervention [risk ratio (RR) = 0.66, 95% confidence interval (CI) = -0.005 – 1.37]. Interventions tailored to people with SMI were perceived as acceptable. Implementation strategies concentrated on overcoming practical challenges at the participant/user level. Conclusion No evidence of the effectiveness of digital interventions to support smoking cessation in people with SMI was found. The importance of tailoring interventions to the needs of people with SMI is highlighted. Robust reporting of implementation is required to enhance future efforts to support smoking cessation in adults with SMI. IMPLICATIONS The findings of this review add to the emerging evidence on digital interventions to support smoking cessation among people with SMI. We highlight the importance of tailoring interventions to the population, particularly considering the role of mental illness and the side effects of psychotropic medication in the accessibility and usability of digital interventions.

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Feasibility of remote delivery of a smoking cessation intervention for people with severe mental illness: a telephone consultation

Ul Haq,

Aslam,

Mazumdar

et al. 2024

Global Health Research

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Background The COVID-19 pandemic meant that face-to-face delivery of a smoking cessation intervention in India and Pakistan for people with severe mental illness within a feasibility trial was not possible. Rather than halt the feasibility trial, the decision was taken to adapt the intervention for remote delivery. This paper presents a telephone consultation conducted with key stakeholders to inform this adaptation. Objective To consult with key stakeholders on the feasibility, challenges and solutions for remote delivery of a smoking cessation intervention for people with severe mental illness in India and Pakistan. Design Rapid mixed-methods telephone consultation. Setting Two mental health facilities, one in Bengaluru, India, and the other in Rawalpindi, Pakistan. Participants Thirty-two members (16 India, 16 Pakistan) of Community Advisory Panels at the mental health facilities. Members were people with severe mental illness (2 India, 8 Pakistan), caregivers (3 India, 2 Pakistan) and professionals (11 India, 6 Pakistan). Data collection and analysis Questions explored general views on remote intervention delivery and specific feedback on nine intervention components (providing information, advising, asking questions, discussion, assessing motivation, using a flipbook, recording activities in a booklet, measuring exhaled carbon monoxide and administering medication). Telephone consultations were audio-recorded. Descriptive statistics were used for quantitative data, content analysis for qualitative data and then triangulated. Results All three participant groups identified challenges and solutions. Overall remote delivery was considered feasible with a preference for telephone sessions, supplemented with video, delivered for 30 minutes in the morning. Except for measuring carbon monoxide, all components were seen to be feasible, with more positive opinions evident in India. The key challenge related to achieving effective communication over the phone, especially for people with severe mental illness or low literacy. Access (connectivity and phone ownership) and monitoring medication use were other challenges. Popular solutions were to involve caregivers in all intervention components and to ensure these components and associated resources were appropriate for this patient group including those with low literacy. Based on this valuable feedback, the smoking cessation intervention was adapted for hybrid (remote and face-to-face) delivery instead of exclusive remote delivery with significant changes made to its delivery and content. Limitations This was a rapid consultation with a small sample of stakeholders. There were missing quantitative data in Pakistan. Conclusions Key stakeholders viewed remote delivery of the smoking cessation intervention among people with severe mental illness as feasible and particularly important when face-to-face delivery is not possible. The intervention was subsequently adapted for hybrid (remote and face-to-face) delivery. Future work Evaluating the feasibility and acceptability of hybrid delivery of this smoking cessation intervention was completed. A full trial commences in July 2024. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Global Health Research programme as award number 17/63/130.

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Telephone based smoking cessation intervention for adults with serious mental illness during the COVID-19 pandemic

Cited by 3 publications

References 13 publications

The Whole Package: A Multi-Component Smoking Cessation Intervention for Adults With Serious Mental Illness: A Qualitative Study

The Whole Package: A Multi-Component Smoking Cessation Intervention for Adults With Serious Mental Illness: A Qualitative Study

Effectiveness and Experience of Implementing Digital Interventions to Promote Smoking Cessation Among Adults With Severe Mental Illness: A Systematic Review and Meta-analysis

Feasibility of remote delivery of a smoking cessation intervention for people with severe mental illness: a telephone consultation

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