psychiatric hospitals who take part in smoking cessation programmes during their
stay are more likely to be smoke-free after 18 months, compared to patients who
don't participate in the programmes, says a new study.
What's more, researchers found that quitting smoking appeared to be safe for
the patients and was tied to a decreased risk of being admitted back into the
hospital."That's a new finding and it needs to be replicated, but we're
excited that it didn't cause any harm and may have supported their
recovery," said Judith Prochaska, the study's lead author from the
Stanford Prevention Research Center in California.
Prochaska and her colleagues write in the American Journal of Public Health
that it's estimated people with mental illnesses use two to four times more
tobacco than the general population.
The lives of people with serious mental illnesses are about 25 years shorter than
the rest of the population, on average, and the main causes of early death are
tobacco-related diseases. Most US hospitals have been smoke-free since 1993,
but at least half of hospital psychiatric units allow smoking and sell
cigarettes, according to the researchers.
"It used to be that people with mental illnesses had a waiver," Dr
Steven Schroeder, the Distinguished Professor of Health and Health Care at the
University of California, San Francisco (UCSF), told Reuters Health. Schroeder,
who was not involved with the new research, said some people believed
psychiatric inpatients were not ready or didn't want to quit smoking and that
giving up smoking might make their conditions worse.
For the new
study, Prochaska and her colleagues recruited smokers between July 2006 and
December 2008 from an inpatient psychiatry unit on the UCSF medical school
campus. The psychiatric unit was a smoke-free environment, but the researchers
write that few smokers were offered or referred for smoking cessation
recruited 224 patients who had smoked at least five cigarettes per day before
their hospitalisation, were at least 18 years old and spoke fluent English. The
most common psychiatric diagnoses were depression and schizophrenia. The
researchers randomly assigned 111 of the participants to receive the usual care
provided by the psychiatric unit and 113 to receive smoking cessation
cessation treatment consisted of determining where a person was in the process
of quitting at the start of the programme, completing a computer programme and a counselling
session, and receiving free nicotine replacement patches for up to six months
after hospitalisation. Letters were also mailed to patients' primary care
doctors requesting their support.
Results of the study
months, 3% of the usual care group had not smoked a cigarette in seven days.
That compared to about 14% among those who went through the smoking cessation
programme. By 18 months, about 8% of the usual care group was smoke-free,
compared to 20% of patients assigned to the programme.
researchers say people without psychiatric illnesses who participate in smoking
cessation programmes have a quit rate of about 25%.
and her colleagues also found that patients who received usual care were almost
twice as likely to be hospitalised for psychiatric treatment again as those who
went through the programme."I think this is a really important paper that
they did. In a way, it really challenges psychiatric hospitals to address
something they've been neglecting for some time," Dr Nancy Rigotti, a
professor of medicine at Harvard Medical School in Boston who has studied
tobacco control, said.
hospitals can adopt something like this and benefit patients in an additional
way other than treating the illness that brought them into the hospital,"
Rigotti, who was not involved with the new study, told Reuters Health.
said her team is currently working with a health economist to examine the cost
effectiveness of the programme, and that it's looking "encouraging".