Nonmedication Smoking Reduction Program for Inpatients With Chronic Schizophrenia

Department of Community Mental Health, University of Haifa, Haifa, Israel.
The Journal of nervous and mental disease (Impact Factor: 1.69). 02/2012; 200(2):142-6. DOI: 10.1097/NMD.0b013e3182438e92
Source: PubMed


People with schizophrenia are more likely to smoke, and to smoke more frequently, than those without schizophrenia. Furthermore, inpatients smoke even more frequently compared with those living in the community. In light of this, we implemented and assessed a smoking reduction intervention using a wide array of behavioral group techniques and methods in chronic hospitalized schizophrenic clients. Using a controlled design, we randomly assigned chronic schizophrenic clients to either a five-session smoking reduction intervention (n = 35) or a waiting list (WL; n = 18). We assessed self-reported smoking behavior, clinical status (Positive and Negative Syndrome Scale, Hamilton Rating Scale for Depression; Clinical Global Impression Scale for Psychosis), subjective quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire-abbreviated version), and weight before and 3 months after the intervention. The intervention successfully reduced the number of cigarettes smoked compared with nonintervention. No clinical worsening or weight gain was observed. Behavioral group-oriented smoking reduction interventions can significantly reduce smoking behavior in hospitalized chronic clients with schizophrenia.

6 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study examined gender differences in smoking and quitting among individuals diagnosed with schizophrenia in Korea. In addition, the study investigated differences in caffeine use by gender and smoking status. An anonymous self-report survey was conducted with psychiatric inpatients. Compared to males, females were less likely to be current smokers (P<.001) and more likely to be former smokers (P<.01). Females were also less likely to be daily caffeine users (P<.001). Having more years of education (P<.05) and higher nicotine dependence scores (P<.05) were associated with decreased odds of intending to quit smoking, whereas having more previous quit attempts (P<.01) was associated with increased odds. These findings were significant even after adjusting for gender. Smokers were more likely to be daily caffeine users (P<.001) than their non-smoking counterparts. Nurses in Korea should play an active role in tobacco control for patients with schizophrenia by providing cessation counseling and educating the effect of caffeine use on cigarette consumption, while tailoring the service to gender differences found in this study.
    Archives of psychiatric nursing 10/2013; 27(5):241-5. DOI:10.1016/j.apnu.2013.06.002 · 0.85 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Tobacco dependence is the most common substance use disorder in adults with mental illness. The prevalence rates for tobacco dependence are two to four times higher in these patients than in the general population. Smoking has a strong, negative influence on the life expectancy and quality of life of mental health patients, and remains the leading preventable cause of death in this group. Despite these statistics, in some countries smokers with mental illness are disadvantaged in receiving intervention and support for their tobacco dependence, which is often overlooked or even tolerated. This statement from the European Psychiatric Association (EPA) systematically reviews the current evidence on tobacco dependence and withdrawal in patients with mental illness and their treatment. It provides seven recommendations for the core components of diagnostics and treatment in this patient group. These recommendations concern: (1) the recording process, (2) the timing of the intervention, (3) counselling specificities, (4) proposed treatments, (5) frequency of contact after stopping, (6) follow-up visits and (7) relapse prevention. They aim to help clinicians improve the care, health and well-being of patients suffering from mental illness.
    European Psychiatry 01/2014; 29(2). DOI:10.1016/j.eurpsy.2013.11.002 · 3.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Persons with a mental disorder smoke at higher rates and suffer disproportionate tobacco-related burden than the general population. The aim of this study was to determine if a smoking cessation intervention initiated during a psychiatric hospitalisation and continued post-discharge was effective in reducing smoking behaviours among persons with a mental disorder. Methods: A randomised controlled trial was conducted at an Australian inpatient psychiatric facility. Participants were 205 patient smokers allocated to a treatment as usual control (n = 101), or a smoking cessation intervention (n = 104) incorporating psychosocial and pharmacological support for four months post-discharge. Follow-up assessments were conducted at one week, two, four and six months post-discharge and included: abstinence from cigarettes, quit attempts, daily cigarette consumption and nicotine dependence. Results: Rates of continuous and seven-day point-prevalence abstinence did not differ between treatment conditions at the six month follow-up, however, point prevalence abstinence was significantly higher for intervention (11.5%) than control (2%) participants at four months (OR = 6.46, p = .01). Participants in the intervention condition reported significantly more quit attempts (F [1,202.5] = 15.23, p = .0001), and lower daily cigarette consumption (F [4, 586] = 6.5, p < .001) and levels of nicotine dependence (F [3, 406] = 8.5, p <.0001) than controls at all follow-up assessments. Conclusions: Post-discharge cessation support was effective in encouraging quit attempts and reducing cigarette consumption up to six months post-discharge. Additional support strategies are required to facilitate longer term cessation benefits for smokers with a mental disorder.
    Nicotine & Tobacco Research 05/2014; DOI:10.1093/ntr/ntu097 · 3.30 Impact Factor
Show more