What do persons with mental illnesses need to quit smoking? Mental health consumer and provider perspectives.

Morris, Chad; Waxmonsky, Jeanette; May, Mandy G.; Giese, Alexis A.

doi:10.2975/32.4.2009.276.284

Cited by 52 publications

(76 citation statements)

References 48 publications

(49 reference statements)

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“…This perception appeared to arise from beliefs that patients would not be interested in quitting smoking 39, 40, 41, 42, that patients would be unable to quit smoking successfully 35, 36, 40 and the view that smoking cessation would be too much for patients to cope with alongside their other issues 36, 39, 41, 42, 43. A minority of studies reported concerns about the negative consequences of quitting smoking, such as concerns about a negative impact on psychiatric symptoms/abstinence 36, 41, the potential effects on medication 36 and a fear that smoking cessation may make patients violent 36.…”

Section: Resultsmentioning

confidence: 99%

“…A perceived lack of opportunity to provide smoking cessation support was evident 36, 39, 40, 41, 42, 43. This generally arose from a perceived lack of treatment resources either on‐site or to refer patients to off‐site 36, 40, 41, 42 and a lack of guidance for implementing smoking cessation treatment alongside treatment for patients' primary disorders 36, 41, 42, 43.…”

Section: Resultsmentioning

confidence: 99%

“…This generally arose from a perceived lack of treatment resources either on‐site or to refer patients to off‐site 36, 40, 41, 42 and a lack of guidance for implementing smoking cessation treatment alongside treatment for patients' primary disorders 36, 41, 42, 43. In addition, a lack of staff 36, 41, staff time 36, 39, funding 36, 40 and support from management 36, 41 were identified as further barriers to providing smoking cessation treatment.…”

Section: Resultsmentioning

confidence: 99%

“…In a number of studies, staff did not appear to feel that they had the capability to treat nicotine dependence effectively 36, 40, 41, 43. This arose both from a lack of knowledge about nicotine dependence and pharmacological treatments 36, 40, 41, 43 and from a perceived need for specialized training in the provision of smoking cessation support to people with mental illnesses and/or drug and alcohol disorders 40, 41, 43.…”

Section: Resultsmentioning

confidence: 99%

“…The behaviour of MHPs was identified commonly as a barrier to addressing smoking among patients 35, 40, 41, 42. This tended to relate to professionals' smoking status, as staff smoking was viewed as providing a bad example to patients 35, 36, 40, 41, 42 and could potentially undermine motivation to address patients' smoking (e.g.…”

Section: Resultsmentioning

confidence: 99%

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A mixed-method systematic review and meta-analysis of mental health professionals' attitudes toward smoking and smoking cessation among people with mental illnesses

et al. 2016

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Background and aimsPeople with mental illnesses and substance abuse disorders are important targets for smoking cessation interventions. Mental health professionals (MHPs) are ideally placed to deliver interventions, but their attitudes may prevent this. This systematic review therefore aimed to identify and estimate quantitatively MHPs attitudes towards smoking and main barriers for providing smoking cessation support and to explore these attitudes in‐depth through qualitative synthesis.MethodsThe online databases AMED, EMBASE, Medline, PsychINFO, HMIC and CINAHL were searched in March 2015 using terms relating to three concepts: ‘attitudes’, ‘mental health professionals’ and ‘smoking cessation’. Quantitative or qualitative studies of any type were included. Proportions of MHPs' attitudes towards smoking and smoking cessation were pooled across studies using random effects meta‐analysis. Qualitative findings were evaluated using thematic synthesis.ResultsThirty‐eight studies including 16 369 participants were eligible for inclusion. Pooled proportions revealed that 42.2% [95% confidence interval (CI) = 35.7–48.8] of MHPs reported perceived barriers to smoking cessation interventions, 40.5% (95% CI = 30.4–51.0) negative attitudes towards smoking cessation and 45.0% (95% CI = 31.9–58.4) permissive attitudes towards smoking. The most commonly held beliefs were that patients are not interested in quitting (51.4%, 95% CI = 33.4–69.2) and that quitting smoking is too much for patients to take on (38%, 95% CI = 16.4–62.6). Qualitative findings were consistent with quantitative results, revealing a culture of smoking as ‘the norm’ and a perception of cigarettes as a useful tool for patients and staff.ConclusionsA significant proportion of mental health professionals hold attitudes and misconceptions that may undermine the delivery of smoking cessation interventions; many report a lack of time, training and confidence as main barriers to addressing smoking in their patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

A mixed-method systematic review and meta-analysis of mental health professionals' attitudes toward smoking and smoking cessation among people with mental illnesses

et al. 2016

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Perceptions of smoking cessation and a novel psychosocial intervention for quitting among individuals with psychosis: A qualitative study

Moe

Keller‐Hamilton

Lee

et al. 2021

Journal Community Psychology

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Individuals diagnosed with psychosis have high rates of smoking‐related morbidity and early mortality. Only a small proportion of these smokers will attempt to quit, and many existing cessation interventions have limited effectiveness. To explore the unique and potentially unmet cessation needs of individuals with psychosis, we sought first‐person experiences with smoking cessation and reactions to a proposed intervention. Twenty‐four smokers with psychosis participated in focus group interviews. Multiple participants reported previous quit attempts using pharmacotherapy or behavioral methods, but few indicated they had previously tried cessation counseling. Though some individuals reported modest success with cessation, most participants tended to express negative perceptions of many available cessation approaches. When informed about the development of a novel smoking cessation intervention, participants had mixed but generally positive perceptions. Smokers diagnosed with psychosis are interested in sustained, individualized delivery of cessation services as part of their broader mental health care.

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Smoking Reduction for Persons with Mental Illnesses: 6-Month Results from Community-Based Interventions

Morris

Waxmonsky

May

et al. 2011

Community Ment Health J

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Persons with mental illnesses use tobacco at significantly higher and heavier rates than the general population, and suffer greater tobacco- related morbidity and mortality. However, there are few existing tobacco cessation interventions for these individuals. This study examined two tobacco cessation interventions, a telephonic quitline intervention (counseling and nicotine replacement therapy) and a community-based group counseling intervention with adults currently receiving community mental health services. At 6-month follow-up, both groups demonstrated significantly reduced tobacco use, but participants who received both quitline services and the group counseling intervention were significantly more likely to have a 50% tobacco use reduction. Across groups, the overall intent-to-treat cessation rate was 7%. Tobacco dependence, depression symptoms, and psychotic symptoms decreased significantly for all treatment groups, while health and mental health functioning increased. Findings suggest that common community tobacco cessation services are effective for this population.

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What do persons with mental illnesses need to quit smoking? Mental health consumer and provider perspectives.

Abstract: These findings are instructive in developing appropriate tobacco cessation services for this population. Specifically, these data have been incorporated into a mental health provider toolkit for smoking cessation and have informed the development of a tobacco cessation intervention study.

Cited by 52 publications

References 48 publications

A mixed-method systematic review and meta-analysis of mental health professionals' attitudes toward smoking and smoking cessation among people with mental illnesses

A mixed-method systematic review and meta-analysis of mental health professionals' attitudes toward smoking and smoking cessation among people with mental illnesses

Perceptions of smoking cessation and a novel psychosocial intervention for quitting among individuals with psychosis: A qualitative study

Smoking Reduction for Persons with Mental Illnesses: 6-Month Results from Community-Based Interventions

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