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Outcomes of a tobacco treatment programme for individuals with severe and persistent mental illness attending a community mental health team

Published online by Cambridge University Press:  09 August 2013

Joy E. Masuhara
Affiliation:
Vancouver Coastal Health Mental Health and Addictions Services
Tom Heah
Affiliation:
Vancouver Coastal Health Mental Health and Addictions Services
Chizimuzo T.C. Okoli*
Affiliation:
University of Kentucky College of Nursing
*
Address for correspondence: Chizimuzo T.C. Okoli, PhD, MPH Assistant Professor and Director, Tobacco Treatment and Prevention Division, Tobacco Policy Research Program, University of Kentucky College of Nursing, 517 College of Nursing Building, Lexington, KY 40536-0232, Office: 859-323-6606, Cell: 859-866-8508, Fax: 859-323-1057, Email: [email protected]

Abstract

Introduction: Individuals with severe and persistent mental illnesses have a greater prevalence of smoking than the general population and are disproportionately affected by tobacco-related morbidity and mortality. Evidence-based tobacco treatment can aid such populations in their efforts at smoking cessation. Few studies have examined the effectiveness of tobacco treatment programmes within Mental Health and Addictions Services in Canada.

Aims: This study examines outcomes from an evidence-based tobacco treatment programme provided within community mental health services in Vancouver, Canada.

Methods: A retrospective chart review was conducted of 134 participants (from June 2010 to February 2012). Information on demographics, tobacco use and cessation history, substance use history, psychiatric disorder diagnosis, expired carbon monoxide level, and duration of treatment in the programme were obtained. Programme completion and smoking cessation/reduction were examined.

Results: Sixty-seven per cent completed the programme. Of those who completed, 26.7% were abstinent at the end-of-treatment and 50% (of those not achieving abstinence) reduced their consumption to at least 50% of their baseline cigarette consumption. Predictors of smoking cessation included having a social support for smoking cessation and lower nicotine dependence at baseline.

Conclusions: Evidence-based tobacco treatment within community mental health services is well received by individuals with severe and persistent mental illness. Such treatment can aid in their efforts towards smoking cessation. Future studies may need to assess factors that can enhance the integration of tobacco treatment within mental health services while providing tailored treatment that addresses the unique needs of smokers who have severe and persistent mental illness.

Type
Articles
Copyright
Copyright © The Author(s) 2013 

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References

Addington, J. (1998). Group treatment for smoking cessation among persons with schizophrenia. Psychiatric Services, 49 (7), 925928.Google Scholar
Bailey, S. R., Bryson, S. W., & Killen, J. D. (2011). Predicting successful 24-Hr quit attempt in a smoking cessation intervention. Nicotine & Tobacco Research, 13 (11), 10921097.Google Scholar
Baker, A., Richmond, R., Haile, M., Lewin, T. J., Carr, V. J., Taylor, R. L.et al. (2006). A randomized controlled trial of a smoking cessation intervention among people with a psychotic disorder. American Journal of Psychiatry, 163 (11), 19341942.Google Scholar
Banham, L., & Gilbody, S. (2010). Smoking cessation in severe mental illness: what works? Addiction, 105 (7), 11761189.Google Scholar
Barnes, M., Lawford, B. R., Burton, S. C., Heslop, K. R., Noble, E. P., Hausdorf, K.et al. (2006). Smoking and schizophrenia: is symptom profile related to smoking and which antipsychotic medication is of benefit in reducing cigarette use? Australian and New Zealand Journal of Psychiatry, 40 (6–7), 575580.Google Scholar
Brown, S., Barraclough, B., & Inskip, H. (2000). Causes of the excess mortality of schizophrenia. The British Journal of Psychiatry, 177 (3), 212217.Google Scholar
Cameron, I. M., Crawford, J. R., Lawton, K., & Reid, I. C. (2008). Psychometric comparison of PHQ-9 and HADS for measuring depression severity in primary care. British Journal of General Practice, 58 (546), 3236.Google Scholar
de Leon, J., & Diaz, F. J. (2005). A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophrenia Research, 76 (2–3), 135157.Google Scholar
Dorner, T. E., Tröstl, A., Womastek, I., & Groman, E. (2011). Predictors of short-term success in smoking cessation in relation to attendance at a smoking cessation program. Nicotine & Tobacco Research.Google Scholar
el-Guebaly, N., Cathcart, J., Currie, S., Brown, D., & Gloster, S. (2002). Smoking cessation approaches for persons with mental illness or addictive disorders. Psychiatric Services, 53 (9), 11661170.Google Scholar
Fiore, M., Jaén, C., Baker, T., Bailey, W., Benowitz, N., Curry, S.et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service.Google Scholar
Gershon Grand, R. B., Hwang, S., Han, J., George, T. P., & Brody, A. L. (2007). Short-term naturalistic treatment outcomes in cigarette smokers with substance abuse and/or mental illness. Journal of Clinical Psychiatry, 68 (6), 892898.Google Scholar
Goldie, C. L., Masuhara, E., Heah, T., Okoli, C., & Johnson, J. (2012). Outpatient tobacco dependence treatment for individuals with mental disorders: The Butt-Out program pilot study outcomes Canadian Journal of Community Mental Health, 31 (1), 8798.CrossRefGoogle Scholar
Hanson, B. S., Isacsson, S.-O., Janzon, L., & Lindell, S.-E. (1990). Social support and quitting smoking for good. Is there an association? Results from the population study, ‘men born in 1914,’ Malmö, Sweden. Addictive Behaviors, 15 (3), 221233.Google Scholar
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86 (9), 11191127.Google Scholar
Hosmer, D., & Lemeshow, S. (2000). Applied Logistic Regression (2nd ed.). New York: Wiley.Google Scholar
Hughes, J. R., & Carpenter, M. J. (2006). Does smoking reduction increase future cessation and decrease disease risk? A qualitative Review. Nicotine & Tobacco Research, 8 (6), 739749.Google Scholar
Johnson, J., Ratner, P., Malchy, L., Okoli, C., Procyshyn, R., Bottorff, J.et al. (2010). Gender-specific profiles of tobacco use among non-institutionalized people with serious mental illness. BMC Psychiatry, 10 (1), 101.Google Scholar
Kahler, C. W., LaChance, H. R., Strong, D. R., Ramsey, S. E., Monti, P. M., & Brown, R. A. (2007). The commitment to quitting smoking scale: Initial validation in a smoking cessation trial for heavy social drinkers. Addictive Behaviors, 32 (10), 24202424.Google Scholar
Kalman, D., Morissette, S. B., & George, T. P. (2005). Co-morbidity of smoking in patients with psychiatric and substance use disorders. The American Journal on Addictions, 14 (2), 106123.Google Scholar
Khara, M., & Okoli, C. T. C. (2011). The Tobacco-Dependence Clinic: Intensive tobacco-dependence treatment in an addiction services outpatient setting. The American Journal on Addictions, 20 (1), 4555.Google Scholar
Lawn, S. J., Pols, R. G., & Barber, J. G. (2002). Smoking and quitting: a qualitative study with community-living psychiatric clients. Social Science & Medicine, 54 (1), 93104.Google Scholar
May, S., & West, R. (2000). Do social support interventions (‘buddy systems’) aid smoking cessation? A review. Tobacco Control, 9 (4), 415422.Google Scholar
McChargue, D. E., Gulliver, S. B., & Hitsman, B. (2002). Would smokers with schizophrenia benefit from a more flexible approach to smoking treatment? Addiction, 97 (7), 785793.Google Scholar
Middleton, E. T., & Morice, A. H. (2000). Breath carbon monoxide as an indication of smoking Habit. Chest, 117 (3), 758763.Google Scholar
Miller, B. J., PaschallC. B., III C. B., III, & Svendsen, D. P. (2006). Mortality and medical comorbidity among patients with serious mental illness. Psychiatric Services, 57 (10), 14821487.Google Scholar
Morisano, D., Bacher, I., Audrain-McGovern, J., & George, T. P. (2009). Mechanisms underlying the comorbidity of tobacco use in mental health and addictive disorders. Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, 54 (6), 356367.Google Scholar
Murray, R. P., Johnston, J. J., Dolce, J. J., Lee, W. W., & O'Hara, P. (1995). Social support for smoking cessation and abstinence: The lung health study. Addictive Behaviors, 20 (2), 159170.Google Scholar
Newcomer, J. W., & Hennekens, C. H. (2007). Severe mental illness and risk of cardiovascular disease. JAMA: The Journal of the American Medical Association, 298 (15), 17941796.Google Scholar
Osborn, D. P. J., Levy, G., Nazareth, I., Petersen, I., Islam, A., & King, M. B. (2007). Relative risk of cardiovascular and cancer mortality in people with severe mental illness from the United Kingdom's General Practice Research Database. Archives of General Psychiatry, 64 (2), 242249.Google Scholar
Prochaska, J. J. (2011). Smoking and mental illness – breaking the link. New England Journal of Medicine, 365 (3), 196198.Google Scholar
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51 (3), 390395.Google Scholar
Ross, L., Thomsen, B. L., Boesen, S. H., Frederiksen, K., Lund, R., Munk, C.et al. (2013). Social relations and smoking abstinence among ever-smokers: A report from two large population-based Danish cohort studies. Scandinavian Journal of Public Health, 41 (5), 531540.Google Scholar
Sandyk, R. (1993). Cigarette smoking: Effects on cognitive functions and drug-induced parkinsonism in chronic schizophrenia. International Journal of Neuroscience, 70 (3–4), 193197.Google Scholar
Selby, P., Voci, S. C., Zawertailo, L. A., George, T. P., & Brands, B. (2010). Individualized smoking cessation treatment in an outpatient setting: Predictors of outcome in a sample with psychiatric and addictions co-morbidity. Addictive Behaviors, 35 (9), 811817.Google Scholar
Siru, R., Hulse, G. K., & Tait, R. J. (2009). Assessing motivation to quit smoking in people with mental illness: a review. Addiction, 104 (5), 719733.Google Scholar
Tsoi, D. T., Porwal, M., & Webster, A. C. (2010). Interventions for smoking cessation and reduction in individuals with schizophrenia. Cochrane Database of Systematic Reviews (6).Google Scholar
Ziedonis, D., Hitsman, B., Beckham, J. C., Zvolensky, M., Adler, L. E., Audrain-McGovern, J., et al. (2008). Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report. Nicotine & Tobacco Research, 10 (12), 16911715.Google Scholar