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New intervention doubles quit rate among smokers with severe mental illness

Posted on 8 April 2019

A dedicated intervention to help people with severe mental illness stop smoking can double quit rates at six months compared to standard care, research by the University of York has revealed.

The team looked at the number of pregnancies alongside smoking exposure data in 30 developing countries.

Led by the University of York’s Mental Health and Addiction Research Group, SCIMITAR+ is the largest ever trial to support smoking cessation among people who use mental health services.

Smoking rates among people with mental health conditions are among the highest of any group having changed little over the last 20 years, while other smokers have quit. This new study demonstrates that with the right support this inequality could be a thing of the past.

Mental health nurses were trained to deliver evidence-based behavioural support to smokers with severe mental illness in smokers’ homes, alongside providing access to Nicotine Replacement Therapy (NRT) and medications.

Specialist support

The researchers found that smokers who received this support were more than twice as likely to have quit six months following the intervention than smokers who had received standard care, usually a referral to the local stop smoking service.

Professor Simon Gilbody, lead researcher from the University of York’s Department of Health Sciences and Hull York Medical School, said: “People with mental health conditions die on average 10 – 20 years earlier than the general population, and smoking is the single largest factor in this shocking difference.

"Our results show that smokers with severe mental illness can successfully quit when given the right support. We hope our findings will mean that this specialist support is available to everyone who might benefit.”

Dedicated pathway

The NHS Long Term Plan published in January commits to developing a dedicated pathway of support to help long-term users of mental health services quit smoking. The Mental Health and Smoking Partnership recommends that the learning from this study is incorporated into routine practice nationally.

Professor Tim Kendall, National Clinical Director for Mental Health at NHS England, said: “This exciting new research will help inform our work to implement the NHS Long Term Plan and deliver the best possible support for smokers with mental health conditions to quit.

"Narrowing the gap in life expectancy experienced by people with mental health conditions must be a priority for everyone working in the NHS and helping smokers to quit is a key route to achieving this.”

Step-up support

Ann McNeill, Professor of Tobacco Addiction at King’s College London and co-chair of the Mental Health and Smoking Partnership, said:“The Mental Health and Smoking Partnership welcome the findings from this study. Smokers with severe mental illness have been ignored for far too long – and it is fantastic to see that changing.

"We hope that NHS England will take these findings into account when implementing the ambition of the NHS Long Term Plan. Most smokers with a mental health condition live in the community, meaning community and primary care services also need to step-up the support they’re providing if we’re to narrow the gap in life expectancy. SCIMITAR shows how this can be done effectively.”

Further information:

  • The Mental Health and Smoking Partnership is a coalition of organisations committed to improving the health and lives of people with mental health conditions. It is jointly chaired by Professor Ann McNeill of UKCTAS and the National Addictions Centre King’s College London, and Professor Paul Burstow, Chair of Tavistock and Portman NHS Foundation Trust and Chair of the Social Care Institute for Excellence. 
  • A full list of Mental Health & Smoking Partnership members can be seen at: http://smokefreeaction.org.uk/smokefree-nhs/smoking-and-mental-health/mental-health-and-smoking-partnership-members/

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About this research

The research is published in the Lancet Psychiatry and was funded by National Institute for Health Research (NIHR). Professor Simon Gilbody is the director of the Mental Health and Addiction Research Group (MHARG) at the University of York and the chief investigator for the SCIMITAR+ study. Other collaborators included the universities of Manchester, Leeds, UCL and Sheffield. Explore our research