The challenge of reducing smoking in people with serious mental illness

Sharma, Ranjana; Gartner, Coral; Hall, Wayne

doi:10.1016/s2213-2600(16)30228-4

Cited by 49 publications

(44 citation statements)

References 130 publications

(79 reference statements)

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“…Smokers with SMI often have greater nicotine dependence and experience substantial difficulty in quitting (McNeill ; Sharma et al . ). Hence, harm reduction strategies which don't require complete abstinence from nicotine may be particularly useful for smokers with SMI who are unable or unwilling to quit smoking using traditional abstinence‐focussed methods (Sharma et al .…”

Section: Discussionmentioning

confidence: 97%

“…Hence, harm reduction strategies which don't require complete abstinence from nicotine may be particularly useful for smokers with SMI who are unable or unwilling to quit smoking using traditional abstinence‐focussed methods (Sharma et al . ). The majority of our respondents agreed that non‐abstinence based approaches were appropriate for reducing the harms caused by smoking among people with SMI.…”

Section: Discussionmentioning

confidence: 97%

“…Whether smokers with SMI should be encouraged to switch to vaping to reduce their health risks is controversial (Sharma et al . ). Our questions about views on switching to vaping as a THR strategy elicited a high proportion of neutral or ‘don't know’ responses, indicating a high degree of uncertainty about this strategy among our respondents.…”

Section: Discussionmentioning

confidence: 97%

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Australian mental health care practitioners’ practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness

Sharma

Bell

Ford

et al. 2017

Int J Mental Health Nurs

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Reducing the burden of physical illness among people living with severe mental illnesses (SMI) is a key priority. Smoking is strongly associated with SMIs resulting in excessive smoking related morbidity and mortality in smokers with SMI. Smoking cessation advice and assistance from mental health practitioners would assist with reducing smoking and smoking-related harms in this group. This study examined the attitudes and practices of Australian mental health practitioners towards smoking cessation and tobacco harm reduction for smokers with SMI, including adherence to the 5As (ask, assess, advise, assist and arrange follow up) of smoking cessation. We surveyed 267 Australian mental health practitioners using a cross-sectional, online survey. Most practitioners (77.5%) asked their clients about smoking and provided health education (66.7%) but fewer provided direct assistance (31.1-39.7%). Most believed that tobacco harm reduction strategies are effective for reducing smoking related risks (88.4%) and that abstinence from all nicotine should not be the only goal discussed with smokers with SMI (77.9%). Many respondents were unsure about the safety (56.9%) and efficacy (39.3%) of e-cigarettes. Practitioners trained in smoking cessation were more likely (OR: 2.9, CI: 1.5-5.9) to help their clients to stop smoking. Community mental health practitioners (OR: 0.3, CI: 0.1-0.9) and practitioners who were current smokers (OR: 0.3, CI: 0.1-0.9) were less likely to adhere to the 5As of smoking cessation intervention. The results of this study emphasize the importance and need for providing smoking cessation training to mental health practitioners especially community mental health practitioners.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Australian mental health care practitioners’ practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness

Sharma

Bell

Ford

et al. 2017

Int J Mental Health Nurs

Self Cite

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“…Smoking is seen at far higher rates in populations with mental health problems than the general population, and as a result, people with these illnesses have on average 12-15 years reduced life expectancy than the general population, being more likely to suffer from smoking-related ill health (1). Despite this, many have argued that encouraging smoking cessation should not be a priority for those with severe mental health problems, and indeed could even detract from treatment for their conditions.…”

Section: Smoke-free Policies In Psychiatric Hospitals Might Reduce Stmentioning

confidence: 99%

Smoke-free policies in psychiatric hospitals need resources

Gage

Maynard

2017

The Lancet Psychiatry

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“…There are several possible reasons why people living with severe mental disorders smoke more than those without mental disorders, including: social determinants of health [5,6]; neurobiological links between addiction and mental illness which cause a shared vulnerability [6,7,8,9]; and possibly therapeutic benefits to smoking such as alleviating symptoms of mental illness and side-effects of psychotropic medications, although this is disputed [8,10,11]. …”

Section: Introductionmentioning

confidence: 99%

Views and Preferences for Nicotine Products as an Alternative to Smoking: A Focus Group Study of People Living with Mental Disorders

Ford

Sharma

Fitzgerald

et al. 2016

IJERPH

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Aims and Background: People living with mental disorders experience a disproportionately higher burden of tobacco-related disease than the general population. Long-term substitution with less harmful nicotine products could reduce the tobacco-related harm among this population. This study investigated the views and preferences of people with mental health disorders about different nicotine products and their use as long-term substitutes for cigarettes. Methods: Semi-structured focus group discussion followed by a brief questionnaire. The discussion transcripts were analysed for content and themes and quantitative data summarised with descriptive statistics. Results: Twenty-nine participants took part in four focus groups. Vaping devices were the most acceptable nicotine products discussed; however preferences for nicotine products were individual and varied along aesthetic, pragmatic, sensory and symbolic dimensions. The concept of tobacco harm reduction was unfamiliar to participants, however they generally agreed with the logic of replacing cigarettes with less harmful nicotine products. Barriers to activating tobacco harm reduction included the symbolism of smoking and quitting; the importance placed on health; the consumer appeal of alternatives; and cost implications. Discussion and Conclusions: Engaging this population in tobacco harm reduction options will require communication that challenges black and white thinking (a conceptual framework in which smoking cigarettes or quitting all nicotine are the only legitimate options) as in practice this serves to support the continuance of smoking. Consumers should be encouraged to trial a range of nicotine products to find the most acceptable alternative to smoking that reduces health harms. Providing incentives to switch to nicotine products could help overcome barriers to using less harmful nicotine products among mental health consumers.

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The challenge of reducing smoking in people with serious mental illness

Cited by 49 publications

References 130 publications

Australian mental health care practitioners’ practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness

Australian mental health care practitioners’ practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness

Smoke-free policies in psychiatric hospitals need resources

Views and Preferences for Nicotine Products as an Alternative to Smoking: A Focus Group Study of People Living with Mental Disorders

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