We developed a bespoke smoking cessation intervention (BSC) to help people with serious mental ill health (SMI) cut down or quit smoking. 

The problem

People with SMI problems such as schizophrenia or bipolar disorder are three to four times more likely to smoke than people in the general population. Smoking contributes to poor health, poverty and early death in people with SMI, who on average die 20 to 25 years earlier than those without.

Smoking makes a significant contribution to this health inequality. Whilst smoking rates are falling in the general population, they have remained unchanged among people who use mental health services. For these reasons, it is clear that conventional approaches to smoking cessation might need to be tailored to people with SMI.

The trial

The team developed a bespoke smoking cessation intervention to help people with SMI cut down or quit smoking. This intervention was tested in the SCIMITAR pilot trial which successfully recruited and followed up 97 participants and found that the BSC intervention was acceptable to people with SMI.

Following the pilot trial the SCIMITAR+ trial was conducted to evaluate the clinical effectiveness and the cost effectiveness of the SCIMITAR intervention. The SCIMITAR+ trial recruited 526 people who were randomly allocated to either the BSC intervention or usual smoking cessation services.

The SCIMITAR+ trial found that after six months, participants who received the bespoke intervention were twice as likely to have quit smoking than those who received usual care. The difference was still evident at 12 months, in a combined analysis of pilot and full trial data. The analysis gives the greatest level of statistical power to examine long term quit rates, which are important for individuals, policy makers and mental health services. 

This project commenced on 01/01/2015 and was funded by the NIHR HTA.

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