scholarly journals Investigating changes in patients’ smoking behaviour, tobacco dependence and motivation to stop smoking following a ‘smoke-free’ mental health inpatient stay: results from a longitudinal survey in England

2020 ◽  
Author(s):  
Tom S Ainscough ◽  
Alex Mitchell ◽  
Catherine Hewitt ◽  
Michelle Horspool ◽  
Pete Stewart ◽  
...  
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Smoking Status ◽  
Tobacco Dependence ◽  
Smoking Behaviour ◽  
Cigarette Consumption ◽  
Discharge Data ◽  
Adult Mental Health ◽  
Stop Smoking ◽  
Smoking Index

Abstract Introduction In line with national guidance, mental health Trusts in England are implementing complete smokefree policies. We investigated inpatients’ changes in smoking behaviour, tobacco dependence, vaping and motivation to stop smoking between pre-admission and post-discharge. Methods We surveyed acute adult mental health inpatients from 14 wards in three mental health Trusts in England in 2019. Structured face-to-face and telephone interviews with patients who smoked on or during admission were conducted during the admission period and at 1 week and 1 month after discharge. Data on smoking status; daily cigarette consumption; Heaviness of Smoking Index (HSI); Strength of Urges to Smoke (SUTS); Motivation to Stop Smoking (MTSS) and vaping were collected and analysed using regression and probit models. Results Inpatient smoking prevalence was 51.9%, and a total of 152 of all 555 eligible smokers (27%) were recruited. Attrition was high: 49.3% at the first, and 50.7% at the second follow-up interview. Changes in self-reported smoking status, motivation to quit and vaping did not change significantly over the study period. Cigarette consumption (p<0.001) and Heaviness of Smoking Index (p<0.001) modestly reduced. Frequency and strength of urges to smoke (p=0.011 and 0.012, respectively) decreased modestly after discharge but were scored as high by 57% and 60% of participants during admission respectively. Just over half (56%) reported being offered smoking cessation support on admission. Conclusions This study identified very modest changes in smoking-related outcomes during and after admission and indicates major challenges to smokefree policy implementation, including limited support for patients who smoke. Implications Despite mental health Trusts in England having developed and implemented smokefree policies to meet national guidelines, adherence to these policies and provision of effective smoking cessation and temporary abstinence support for inpatients admitted to acute adult mental health wards appear to be limited. Patients who smoke on admission are likely to continue to do so during admission and after discharge, and only very modest change in smoking behaviours appears to take place. Important opportunities to promote smoking cessation in this population are missed. Barriers to effective support need to be identified and addressed.

Impacts of Canada’s minimum age for tobacco sales (MATS) laws on youth smoking behaviour, 2000–2014

2018 ◽  
Vol 27 (e2) ◽  
pp. e105-e111 ◽  
Author(s):  
Russell Clarence Callaghan ◽  
Marcos Sanches ◽  
Jodi Gatley ◽  
James K Cunningham ◽  
Michael Oliver Chaiton ◽  
...  
Keyword(s):  
Smoking Status ◽  
Age Groups ◽  
Smoking Behaviour ◽  
Cigarette Consumption ◽  
Institute Of Medicine ◽  
Youth Smoking ◽  
Absolute Increase ◽  
Smoking Intensity ◽  
Tobacco Sales ◽  
Minimum Age

BackgroundRecently, the US Institute of Medicine has proposed that raising the minimum age for tobacco purchasing/sales to 21 years would likely lead to reductions in smoking behavior among young people. Surprisingly few studies, however, have assessed the potential impacts of minimum-age tobacco restrictions on youth smoking.ObjectiveTo estimate the impacts of Canadian minimum age for tobacco sales (MATS) laws on youth smoking behaviour.DesignA regression-discontinuity design, using seven merged cycles of the Canadian Community Health Survey, 2000–2014.ParticipantsSurvey respondents aged 14–22 years (n=98 320).ExposureCurrent Canadian MATS laws are 18 years in Alberta, Saskatchewan, Manitoba, Quebec, the Yukon and Northwest Territories, and 19 years of age in the rest of the country.Main outcomesCurrent, occasional and daily smoking status; smoking frequency and intensity; and average monthly cigarette consumption.ResultsIn comparison to age groups slightly younger than the MATS, those just older had significant and abrupt increases immediately after the MATS in the prevalence of current smokers (absolute increase: 2.71%; 95% CI 0.70% to 4.80%; P=0.009) and daily smokers (absolute increase: 2.43%; 95% CI 0.74% to 4.12%; P=0.005). Average past-month cigarette consumption within age groups increased immediately following the MATS by 18% (95% CI 3% to 39%; P=0.02). There was no evidence of significant increases in smoking intensity for daily or occasional smokers after release from MATS restrictions.ConclusionThe study provides relevant evidence supporting the effectiveness of Canadian MATS laws for limiting smoking among tobacco-restricted youth.

scholarly journals Smoking cessation advice after cervical screening: a qualitative interview study of acceptability in Dutch primary care

2018 ◽  
Vol 69 (678) ◽  
pp. e15-e23
Author(s):  
Marthe BL Mansour ◽  
Mathilde R Crone ◽  
Henk C van Weert ◽  
Niels H Chavannes ◽  
Kristel M van Asselt
Keyword(s):  
Smoking Cessation ◽  
Cervical Screening ◽  
Qualitative Interview ◽  
Smoking Behaviour ◽  
Interview Study ◽  
Interactive Approach ◽  
Smear Test ◽  
Stop Smoking ◽  
Qualitative Interview Study ◽  
Practice Assistant

BackgroundCervical cancer screening in general practice could be a routine and opportune moment to advise females who smoke to stop smoking.AimThe aims of this study were to investigate the attitudes of females who smoke to receiving advice about stopping smoking after cervical screening and to identify factors associated with the acceptability of this advice.Design and settingThis qualitative interview study was conducted with Dutch females who smoked, had undergone cervical screening, and were aged 30 to 60 years. Interviews were performed between December 2016 and September 2017.MethodIn this study 15 participants were interviewed and transcripts were analysed using thematic analysis.ResultsFemales who smoke were ambivalent (positive or sceptical) about being advised to stop smoking after they had undergone cervical screening. An explanation of why smoking behaviour is addressed by the practice assistant performing the smear, and making females feel at ease during the smear test, were found to be factors that might influence acceptability of such advice. Although a personal and non-judgemental approach to discussing smoking was considered essential, participants expressed different preferences regarding the form and content of cessation support. This was reflected by the variations in knowledge about smoking cessation support, previous experiences of cessation attempts, and received cessation advice or support.ConclusionStudy participants had mixed opinions about being given advice about smoking cessation after their cervical smear test and differed in their preferences for the type of support for smoking cessation. An interactive approach might improve how well a smoking cessation intervention is received by females who smoke and cater to their individual needs and preferences.

scholarly journals Smoking cessation counselling practices of family physicians in Jordan

2013 ◽  
Vol 8 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Mousa Abdullah Alomari ◽  
Yousef Saleh Khader ◽  
Ali Shakir Dauod ◽  
Khaled Adel Abu-Hammour ◽  
Adi Harbi Khassawneh ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Smoking Status ◽  
Nicotine Patch ◽  
Family Physicians ◽  
Smoking Cessation Counselling ◽  
Quit Smoking ◽  
Self Help ◽  
Stop Smoking ◽  
Two Factors ◽  
Structured Questionnaire

Objectives: To assess the smoking cessation counselling practices of family physicians in Jordan and assess their perception about the availability of smoking cessation resources and about the barriers to effective smoking cessation practices. Methods: A pre-structured questionnaire was distributed to 124 family physicians practicing in teaching and Ministry of Health medical centres in Jordan. All participants were asked about their smoking cessation practices and about the barriers to effective smoking cessation practices. Results: Only 39.8% reported that they assess the willingness of the patients to quit smoking and 28.2% reported that they discuss counselling options with smokers. Considerably fewer percentages of physicians reported that they prepare their patients for withdrawal symptoms (11.6%), discuss pharmacotherapies (4.9%), describe a nicotine patch (5.0%), and provide patients with self-help materials (6.7%). The two factors cited most often by physicians as significant barriers to smoking cessation counselling were lack or too few available cessation programmes (90.3%) and limited training for physicians on tobacco and cessation interventions (90.3%). Conclusion: While a high proportion of Jordanian family physicians reported that they usually ask patients about smoking status and advise them to stop smoking, they do not regularly provide extensive assistance to help their patients to quit smoking. Lack or too few available cessation programmes and limited training for physicians on smoking cessation interventions were identified as the two major barriers to effective smoking cessation counselling.

Queensland smoking care in adult acute mental health inpatient units: Supporting practice change

2020 ◽  
Vol 54 (9) ◽  
pp. 919-927
Author(s):  
Sally Plever ◽  
Irene McCarthy ◽  
Melissa Anzolin ◽  
Brett Emmerson ◽  
John Allan ◽  
...  
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Clinical Practice ◽  
Mental Health Services ◽  
Health Services ◽  
Smoking Status ◽  
Public Mental Health ◽  
Practice Change ◽  
Public Mental Health Services ◽  
Inpatient Units

Objective: To review a clinical practice improvement approach to statewide implementation of smoking care in adult acute mental health inpatient units across public mental health services in Queensland. Method: Queensland public mental health services, with adult acute inpatient units, joined a statewide collaborative to work together to increase the routine screening of smoking and delivery of a Smoking Cessation Clinical Pathway brief intervention to identified smokers. Results: Over a 2-year period, statewide improvements were demonstrated in the recording of smoking status (88–97%) and in the provision of a brief smoking cessation intervention to smokers (38–73%). In addition, all individual mental health services increased the delivery of a brief intervention to identified smokers and the recording of smoking status either improved or remained at high levels. Conclusion: Smoking remains an ongoing challenge for mental health services and one of the most important physical health issues for people living with a mental illness. The ability to implement statewide smoking care in public mental health services is an important step in shifting poor health outcomes. The clinical practice change approach adopted in Queensland has demonstrated encouraging outcomes in improving the delivery of smoking care that has been sustained over a 2-year period.

A Review of Research by Nurses Regarding Tobacco Dependence and Mental Health

2009 ◽  
Vol 27 (1) ◽  
pp. 297-318 ◽  
Author(s):  
Daryl L. Sharp ◽  
Susan W. Blaakman
Keyword(s):  
Mental Health ◽  
Tobacco Use ◽  
Tobacco Dependence ◽  
Mental Illnesses ◽  
Psychiatric Nurses ◽  
System Level ◽  
Clinical Population ◽  
Addictive Disorders ◽  
Stop Smoking ◽  
Free Health Care

The prevalence of tobacco use and dependence among those with psychiatric and/or substance use disorders is exceptionally high, contributing to significant morbidity and mortality. The purpose of this review is to discuss the findings conducted by nurses regarding smoking and mental health. A search of the available literature since 1950 resulted in a review of 17 studies authored or coauthored by nurses. Most study designs were descriptive with only one investigator reporting the results of a small clinical trial. In addition to documenting smoking patterns in this population, investigators found that many psychiatric nurses assessed their clients for tobacco use and advised them to stop smoking but few intervened intensively to aid cessation. Psychiatric nurses reported low efficacy for delivering interventions and considerable doubt about their clients’ abilities and motivation to stop smoking. Although some desired additional training in tobacco dependence interventions, nurses reported feeling ethically conflicted about, and were inconsistently supportive of, system level interventions such as tobacco free health care settings. It is likely that these findings, as well as the paucity of tobacco dependence studies, reflect the relatively small number of psychiatric nurses conducting research as well as the inattention, until recently, of mental health leaders, policy makers, and funders to the importance of tobacco dependence research in this clinical population. As tobacco dependence treatment for those with mental illnesses and/or addictive disorders becomes more of a public health priority, opportunities abound for nurse researchers to contribute to the growing evidence in this often neglected area.

scholarly journals To assess implementation of trust policy (smoke free policy) on an acute mixed mental health ward setting

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S78-S79
Author(s):  
Antigoni Elisseou ◽  
Saika Rahuja
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Smoking Status ◽  
Premature Mortality ◽  
Safe Level ◽  
Smoke Free Policy ◽  
Barriers To Implementation ◽  
Second Hand Smoking ◽  
Brief Advice ◽  
Mental Health Unit

AimsTo assess implementation of Trust Policy (Smoke Free Policy) on the acute adult mental health unit To evaluate barriers to implementation of local standards and NICE guidelines To evaluate if Q-Risk score is being calculated and noted.BackgroundThere are about 34,000 people residents in mental health facilities in England and Wales on any one day (Commission for Healthcare Audit and Inspection 2005) and many of them smoke.Smoke free policy implemented in the GMMH since 1st of July 2018.Smoking is single largest preventable cause of ill health & premature mortality in England.Smoking prevalence is significantly higher among people admitted to hospital due to the mental illness i.e. 70%According to WHO SHS (second hand smoking), is a human carcinogen to which there is no safe level.MethodAn audit tool questionnaire was used to collect the data on the Acute Mixed mental health ward setting i.e. Bronte Ward, Laureate House, Wythenshawe HospitalIdentified method: interview with each patient, PARIS documentation review and Patient's Kardex review.Sample size: 23 and on re-audit 12.Method of data input: Microsoft ExcelData were analyzed by calculating percentageResultThe majority of the patients that took part in the Audit were smokers (91%), a high percentage overall. This indicate how important it is for a plan to be in place regarding smoking on the ward since there is a smoke free policy now in the GMMH. Our results showed that not everyone was asked regarding their smoking status (87%).An important figure that came out from the results was that only 50% of the patients asked about their smoking status were told that there is a smoke free policy.For a smoke free policy ward only 33% of the smokers that took part in the audit were provided with brief advice regarding smoking cessation which shows that there might be a need of a more precise implementation regarding support to receive brief intervention for smoking cessation, NRT and specialist advice.The results also showed that the QRisk is not calculated, a useful marker of cardiovascular risk.ConclusionGive leaflets regarding smoking cessation on admission, offer support and advice to all the patients being on the ward. And re-audit in due course to see the effect of this intervention.

Practices and Perceptions of Mental Health Counselors in Addressing Smoking Cessation

2011 ◽  
Vol 33 (3) ◽  
pp. 264-282 ◽  
Author(s):  
Jaime Sidani ◽  
James Price ◽  
Joseph Dake ◽  
Timothy Jordan ◽  
Joy Price
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Professional Training ◽  
Response Rate ◽  
Smoking Status ◽  
Outcome Expectations ◽  
Mental Health Counselors ◽  
High Confidence ◽  
Cessation Intervention ◽  
Quitting Smoking

This study sought to examine the practices and perceptions of clinical mental health counselors in addressing smoking cessation with clients. A survey instrument was mailed to 700 clinical members of the American Mental Health Counselors Association. Of those who responded (n=330; 53.1% response rate), the majority (58.9%) had not considered asking all clients about their smoking status at every visit. Counselors reported low use of the guidelines for smoking cessation intervention and for recommending pharmacotherapy. Levels of both efficacy and outcome expectations were significantly higher among counselors who reported regular use of smoking cessation interventions. Although 86.7% of counselors reported high confidence in assisting their clients in quitting smoking, there is a dearth of professional training for this.

“Stop smoking!”: Do we say it enough?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17500-e17500
Author(s):  
Jessica Ann Reifer Hildebrand ◽  
Sangeeta Sastry ◽  
Ashley Adams
Keyword(s):  
Smoking Cessation ◽  
Smoking Status ◽  
Medical Center ◽  
Performance Status ◽  
Tobacco Dependence ◽  
Poor Performance Status ◽  
Second Primary ◽  
Smoking Cessation Counseling ◽  
Significant Difference ◽  
Improvement Programs

e17500 Background: There are clear benefits of smoking cessation after the diagnosis of Bronchogenic Carcinoma (BC). Patients who quit smoking after the diagnosis of BC report lower levels of pain and are less likely to develop a second primary tumor when compared to patients who continue to smoke after they are diagnosed. Persistent smoking is also associated with poor performance status and survival outcomes. Evidence suggests that smokers are more likely to quit if they are counseled by their physicians. Yet, there may be a prevailing belief among physicians that treating tobacco dependence is futile in this population. The purpose of this study was to investigate whether physicians addressed smoking cessation with patients who were diagnosed with BC. Methods: A retrospective chart review of patients who were diagnosed with BC was conducted at a community medical center between 2008 and 2010, using the hospital’s cancer registry. Demographic information including age, race, sex, AJCC stage, and smoking status at the time of diagnosis was collected. Evidence of tobacco cessation counseling was sought through billing codes, physician notes, and orders surrounding the time of diagnosis. Results: A total of 948 patients were diagnosed with lung cancer between 2008 and 2010. 438 were current smokers at diagnosis, 422 were former smokers, and 88 had never smoked. Of the 438 smokers, only 36% were counseled on smoking cessation. On average, each patient encountered 3 different physicians in both the inpatient and outpatient settings. Of note, Stage I patients were 1.7 times more likely to be counseled than those with Stage IV disease (p=0.017). There was no significant difference between the counseled group and the non counseled group in regards to age, race, or sex. Conclusions: In spite of evidence that smoking cessation is beneficial even after the diagnosis of BC, physicians are not counseling their patients sufficiently. Reasons physicians may fail to counsel include: an inability to effectively assess tobacco dependence, competing concerns during patient encounters, and reduced awareness of current quality measures. With the implementation of quality improvement programs, we suspect that smoking cessation counseling for patients with BC will improve in the community setting.

scholarly journals Targeted Intervention to Reduce Smoking among People with Severe Mental Illness: Implementation of a Smoking Cessation Intervention in an Inpatient Mental Health Setting

Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 204
Author(s):  
Julia M. Lappin ◽  
Dennis Thomas ◽  
Jackie Curtis ◽  
Stephen Blowfield ◽  
Mike Gatsi ◽  
...  
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Smoking Status ◽  
System Change ◽  
Health Unit ◽  
Post Intervention ◽  
Smoking Cessation Treatment ◽  
Inpatient Mental Health ◽  
Cessation Treatment ◽  
Mental Health Unit

Background and Objectives: Smoking and smoking-related harms are highly prevalent among people with severe mental illness. Targeted smoking cessation programs are much needed in this population. This pilot study aimed to assess the effectiveness of implementing smoking cessation system change interventions within an acute inpatient mental health unit. Materials and Methods: Design: Pre-post intervention study. System change interventions for smoking cessation were delivered over a three-month period (05 March 2018–04 June 2018) on an acute inpatient mental health unit. Participants (n = 214) were all individuals receiving care as inpatients during the three-month intervention. Outcomes assessed pre- and post-intervention were: (i) recording of patient smoking status in medical notes, (ii) number of inpatients offered smoking cessation medication, and iii) number of violent incidents reported. Results: Recording of smoking status significantly increased from 1.9% to 11.4% (X2 = 14.80; p ≤ 0.001). The proportion of inpatients offered smoking cessation treatment significantly increased from 11.0% to 26.8% (X2 = 16.01; p ≤ 0.001). The number of violent incidents decreased by half, which was not statistically significant. Conclusion: Evidence-based smoking cessation interventions can be successfully implemented on an inpatient mental health unit. Modest gains were made in routine screening for smoking and in smoking cessation treatment prescription. Future studies should prioritize effective participatory collaboration with staff to optimize effectiveness of interventions and should include additional strategies such as brief intervention training and smoking cessation treatments such as varenicline and buproprion in addition to nicotine replacement therapy (NRT).

scholarly journals Addressing concerns about smoking cessation and mental health: theoretical review and practical guide for healthcare professionals

2020 ◽  
pp. 1-11
Author(s):  
Gemma M. J. Taylor ◽  
Amanda L. Baker ◽  
Nadine Fox ◽  
David S. Kessler ◽  
Paul Aveyard ◽  
...  
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Healthcare Professionals ◽  
Mental Health Problems ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Evidence Based ◽  
Depression And Anxiety ◽  
Stop Smoking ◽  
Cognitive Behavioural

SUMMARY Smoking rates in people with depression and anxiety are twice as high as in the general population, even though people with depression and anxiety are motivated to stop smoking. Most healthcare professionals are aware that stopping smoking is one of the greatest changes that people can make to improve their health. However, smoking cessation can be a difficult topic to raise. Evidence suggests that smoking may cause some mental health problems, and that the tobacco withdrawal cycle partly contributes to worse mental health. By stopping smoking, a person's mental health may improve, and the size of this improvement might be equal to taking antidepressants. In this article we outline ways in which healthcare professionals can compassionately and respectfully raise the topic of smoking to encourage smoking cessation. We draw on evidence-based methods such as cognitive–behavioural therapy (CBT) and outline approaches that healthcare professionals can use to integrate these methods into routine care to help their patients stop smoking.

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