New intervention doubles quit rate among smokers with severe mental illness - showing inequalities could be a thing of the past

New intervention doubles quit rate among smokers with severe mental illness

Research published today in the Lancet Psychiatry [1] has found a dedicated intervention to help people with severe mental illness stop smoking can double quit rates at six months compared to standard care.

Led by the University of York’s Mental Health Addictions Research Group, SCIMITAR+ is the largest ever trial to support smoking cessation among people who use mental health services [2]. 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 [3]. 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. 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.

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 [4] 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.”

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.”

References:

[1] Full article available here: http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30047-1/fulltext 

[2] Gilbody S. et al. Smoking cessation for people with severe mental ill health: The SCIMITAR+ Trial.Lancet Psychiatry 2019.

[3] Szatkowski & McNeill. Diverging trends in smoking behaviours according to mental health status. Nicotine & Tobacco Research, 2015;3:356-60.

[4] 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/