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Available from: Marc Steinberg, Dec 30, 2014
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    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; DOI:10.1016/j.eurpsy.2013.11.002 · 3.21 Impact Factor
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    ABSTRACT: The high prevalence of smoking and low cessation rates among individuals with schizophrenia and similar conditions are not well understood. Behavioral economics has been extensively applied to studying addictive behavior and may contribute to understanding smoking in this subpopulation. This study compared smokers with schizophrenia or schizoaffective disorder (SS) and control smokers (CS) on indices of cigarette demand and delayed reward discounting, a behavioral economic index of impulsivity. The SS (n=25) and CS (n=24) groups participated in two sessions approximately 1 week apart. During the first session, delay discounting was assessed using the Monetary Choice Questionnaire. During the second session, participants smoked their usual brand ad libitum through a smoking topography assessment device, after which cigarette demand was assessed using a cigarette purchase task. Primary comparisons were of the hyperbolic discounting function, k, and indices of cigarette demand. Compared to the CS group, the SS group exhibited significantly higher intensity of demand, and significantly greater consumption and expenditure across the inelastic portion of the demand curve, but no differences were evident on the other demand indices. No differences were evident for delay discounting. The SS group also exhibited heavier smoking topography and two indices of smoking topography were significantly correlated with demand. These results provide further evidence of higher incentive value of cigarettes among SS individuals, but not greater impulsivity, as measured by discounting. Considerations include potentially important methodological factors and the role of satiation/withdrawal.
    Psychopharmacology 02/2011; 216(1):91-9. DOI:10.1007/s00213-011-2185-8 · 3.99 Impact Factor