Smoking Cessation and Serious Mental Illness
ABSTRACT A focus group methodology was employed to identify personal, social, and environmental factors that affect smoking cessation in persons with serious mental illness. Four focus groups were held: two for those who had attempted to quit smoking and two for those who had never attempted to quit. Smoking is central to daily survival in patients with serious mental illness. Social and environmental reinforcement can both assist and hinder efforts to stop smoking. Smoke-free environments influence decisions to quit smoking if positive social comparisons with nonsmokers occur. Peer modeling and interpersonal connections with nonsmokers can offer links to forming supportive nonsmoking relationships.
SourceAvailable from: Geoffrey L Dickens[Show abstract] [Hide abstract]
ABSTRACT: ACCESSIBLE SUMMARY: Only one in five people in the general population smoke tobacco but most patients in secure and forensic mental health wards are smokers. We need to know why this group are more likely to smoke and why they find it difficult to give up. We could then tailor 'stop smoking' interventions to meet their specific needs. To find out more we compared patients who smoke in secure wards with staff smokers. Compared with staff patients were more dependent on nicotine, less ready to quit smoking, smoked to relieve stress and boredom, and were less concerned about health consequences of smoking. Reasons given by patients for smoking suggest that more work is needed at a pre-quit smoking intervention stage to increase motivation to quit. Once readiness to quit is increased, interventions should focus on reducing cravings; finding alternative methods for coping with stress and boredom and achieving enjoyment from alternative sources. ABSTRACT: People with mental disorder account for a disproportionately large amount of smokers, and the problem is greatest in inpatient settings. 'Stop smoking' services should be tailored to the needs of individual patient groups. It is important therefore to investigate factors relevant to different groups in order to inform future quit smoking interventions. We compared 50 patients and 50 staff in a secure mental health hospital on measures of smoking and smoking motives, nicotine dependence, craving, previous cessation attempts, motivation to quit and quit smoking-related self-efficacy. Patients were significantly more dependent on nicotine with higher levels of craving; were more likely to smoke to cope with stress, for something to do when bored, for enjoyment and pleasure; and reported significantly less readiness to quit smoking. Staff were more likely to cite health concerns as reasons for quitting. Future pre-intervention work with inpatients should focus on increasing their readiness to quit smoking. Once motivation is increased, interventions should include advice on reducing cravings, finding alternative methods for coping with stress and boredom and achieving enjoyment and pleasure from alternative sources.Journal of Psychiatric and Mental Health Nursing 05/2013; 21(6):483-490. DOI:10.1111/jpm.12088 · 0.98 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Objective: This study examined smoking cessation characteristics of smokers who reported seeking mental health treatment Methods: Data for adult current smokers (N=18,939) were combined from the 2000, 2005, and 2010 National Health Interview Survey. Multivariate regressions were used to assess associations between smoking cessation behaviors, cessation-related social norms, and mental health treatment. Results: Smokers (N=1,897) who reported seeing mental health professionals for mental health problems had higher odds of having made attempts to quit in the past year (odds ratio [OR]=1.17), of having used nicotine replacement therapy (OR=1.28), and of using face-to-face counseling (OR=2.40), telephone quit lines (OR=1.81), and support groups (OR=1.63) to assist smoking cessation. They were more likely to have been advised by health professionals to quit smoking (OR=1.62) but less likely to live in a smoke-free home (OR=.78). Use of smoking cessation treatments and prevalence of smoke-free homes increased over the sampling period. Conclusions: Findings highlight the need for tailored efforts to reduce tobacco use among people with mental health problems.Psychiatric Services 07/2014; 65(7-7):957-960. DOI:10.1176/appi.ps.201300444 · 1.99 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: To identify barriers that are common and unique to six selected vulnerable groups: low socioeconomic status; Indigenous; mental illness and substance abuse; homeless; prisoners; and at-risk youth. A systematic review was carried out to identify the perceived barriers to smoking cessation within six vulnerable groups. MEDLINE, EMBASE, CINAHL and PsycInfo were searched using keywords and MeSH terms from each database's inception published prior to March 2014. Studies that provided either qualitative or quantitative (ie, longitudinal, cross-sectional or cohort surveys) descriptions of self-reported perceived barriers to quitting smoking in one of the six aforementioned vulnerable groups were included. Two authors independently assessed studies for inclusion and extracted data. 65 eligible papers were identified: 24 with low socioeconomic groups, 16 with Indigenous groups, 18 involving people with a mental illness, 3 with homeless groups, 2 involving prisoners and 1 involving at-risk youth. One study identified was carried out with participants who were homeless and addicted to alcohol and/or other drugs. Barriers common to all vulnerable groups included: smoking for stress management, lack of support from health and other service providers, and the high prevalence and acceptability of smoking in vulnerable communities. Unique barriers were identified for people with a mental illness (eg, maintenance of mental health), Indigenous groups (eg, cultural and historical norms), prisoners (eg, living conditions), people who are homeless (eg, competing priorities) and at-risk youth (eg, high accessibility of tobacco). Vulnerable groups experience common barriers to smoking cessation, in addition to barriers that are unique to specific vulnerable groups. Individual-level, community-level and social network-level interventions are priority areas for future smoking cessation interventions within vulnerable groups. A protocol for this review has been registered with PROSPERO International Prospective Register of Systematic Reviews (Identifier: CRD42013005761). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.BMJ Open 12/2014; 4(12):e006414. DOI:10.1136/bmjopen-2014-006414 · 2.06 Impact Factor