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UK Paper: Smoking Cessation For People With Mental Health Conditions

An article by former stop-smoking service manager at Leicester City Council, Louise Ross, evaluates the challenges and opportunities in supporting people with poor mental well-being quit smoking.

Diane Caruana

June 11, 2020

Multiple studies and health entities, such as the Royal Australian and New Zealand College of Psychiatrists (RANZCP), have pointed out that mentally ill individuals have a higher tendency to smoke in comparison to the general population. Hence, they benefit greatly from having extra support in relation to smoking cessation and access to safer alternatives, that would at least decrease the likelihood of them also suffering from smoke-related conditions.

“The tar (and not the nicotine) in tobacco smoke also increases the need for higher doses of some psychotropic medications, so stopping smoking enables some people to be prescribed a lower dose and experience fewer side-effects (NCSCT, 2018).”

The third in a series of five, this article reflects on the nurses’ role in offering smoking cessation guidance and support. It starts by pointed out amongst other things, that smokers on psychotropic drugs tend to need higher doses. “The tar (and not the nicotine) in tobacco smoke also increases the need for higher doses of some psychotropic medications, so stopping smoking enables some people to be prescribed a lower dose and experience fewer side-effects (NCSCT, 2018).”

A 2016 report by ASH; The Stolen Years, which was endorsed by the Royal College of Nursing, had challenged health services to cut smoking rates amongst mental health patients to less than 5% by 2035, and an interim target of 35% by 2020.

The target rate for 2020 has been achieved

The article states that the target for 2020 has been achieved thanks to the following factors:

“A strong focus on the skills and training of the workforce;
Better access to medications that will help people to quit;
Improving understanding that e-cigarettes are substantially safer than smoking;
Moving to smoke-free mental health settings, while providing appropriate support for smokers.”

The piece adds that nurses are in an especially good position to promote smoking cessation. Keeping in mind that studies have indicated that smokers respond well to intensive smoking cessation treatments that are tailor made for their needs, nurses who understand individual patients’ needs are ideally placed to give ongoing smoking cessation support.

Training in smoking cessation for nurses

Of course, in order to ensure the effectivity of their support, these health care practitioners need to be well versed in the different smoking cessation treatments available and receive training on what behavioural support and products are most effective.

To this effect, the following free training has been made available:

“Staff training in smoking cessation, featuring a module on mental illness, is available free from the National Centre of Smoking Cessation and Training and includes how to:

Understand the difference between nicotine and tobacco smoke
Deliver very brief advice on smoking
Communicate the risks and benefits of smoking, and quitting smoking, on mental health
Prevent and manage withdrawal symptoms
Improve adherence with stop-smoking medicines and/or e-cigarette”

Read Further: Nursing Times