Tailored tobacco dependence support for mental health patients: A model for inpatient and community services
Author(s)
Camilla Parker, Ann McNeill and Elena Ratschen
Presenter(s)
Dr Elena Ratschen Lecturer in Epidemiology/ Tobacco Control, Faculty of Medicine & Health Sciences, University of Nottingham
Abstract
Tailored tobacco dependence support for mental health patients: A model for inpatient and community services
Aims:
Although smoking prevalence among people with severe mental illness is high, it remains largely unaddressed. This pragmatic pilot project aimed to develop and implement a tailored tobacco dependence service in mental health settings, and to assess its impact, as well as barriers and facilitators to implementation.
Design:
An integrative service model, spanning acute, rehabilitation and community services, including the design of tailored instruments and referral pathways, delivered by two mental health professionals.
Setting/Participants: Four adult acute and two rehabilitation wards (129 beds), and the community recovery team (2038 cases) of the UK' s largest mental health Trust.
Measurements Audit of smoking information in patient notes; service uptake; quit attempts; smoking cessation and reduction; qualitative data on barriers/facilitators to implementation.
Findings:
110 patients attended at least one support session: 53 inpatients (23% of inpatient smokers); and 57 community (of unknown number of community smokers, as recording of smoking status not mandatory). Thirty-four of these (31%) made a quit attempt; 17 (15%) stopped smoking and 29 (26%) reduced cigarette consumption by up to 50% at the final contact. Barriers to service implementation related to the following themes: 1) Trust policy, systems and procedures, 2) staff knowledge and attitudes and 3) illness related factors.
Conclusions:
Establishing a smoking cessation treatment service for people with mental illness proved difficult due to complex systemic barriers. However, there is clearly a demand, by patients, for such a service.
