Abstract
AimsAround thirty percent of smokers have a mental health problem. Smoking cessation has been associated with mental health benefits, but smoking prevalence remains high in populations with mental health problems. This study aimed to assess mental health related knowledge, practice, and training needs of practitioners supporting smoking cessation. MethodsUK stop smoking practitioners (n=717) recruited via a database of a national provider of smoking cessation training in June 2016 sufficiently completed an online survey about available resources, knowledge, confidence, and training needs related to smoking cessation and mental health. Responses were described and compared between practitioners with a mental health lead and those without such a lead in their service using chi-square statistics and t-tests. ResultsA considerable proportion agreed (37%) or were undecided (28.9%) that smoking helped people with mental health problems feel better and agreed (17.2%) or were undecided (30.2%) that cessation would exacerbate mental health symptoms. Only 11.6% said their service had designated funding for smokers with mental health problems and 26.5% were or had a staff member who was a dedicated lead practitioner for mental health work. Practitioners from services that had a dedicated mental health lead were more confident in supporting smokers with different mental health problems and using different pharmacotherapies (all p<0.001) and were more likely to disagree that cessation was detrimental (p=0.001). A majority of practitioners were interested in training, particularly about smoking cessation effects on psychiatric medication (84.3% of n=632) and how to tailor stop smoking support to clients with mental health problems (82.4%). ConclusionPractitioners who support smoking cessation have limited knowledge about mental health and smoking but are willing to learn and improve. However, they are hindered by a lack of resources.
Highlights
Smoking prevalence in England has declined from 27% in 2000 to 16% in 2016 (Office for National Statictics, 2017)
In June 2016, an email invitation to complete an online questionnaire survey was sent to 22,214 email addresses, some outdated, of practitioners who at some point registered for recommended training at a UK national smoking cessation training provider database
Respondents were most likely to be 45 to 54 years old (34.7%), female (82.7%), working as a specialist (43.2%) or community (40.3%) practitioner, employed by a National Health Service (NHS) organisation (26.8%), general practice (25.5%) or pharmacy (18.4%) (Table 1), and had been providing smoking cessation support for an average of 6.2 years (SD = 4.3, 95% CI: 5.9–6.6)
Summary
Smoking prevalence in England has declined from 27% in 2000 to 16% in 2016 (Office for National Statictics, 2017). The improvement, has excluded people with mental health problems, where smoking rates have not significantly changed since the early 1990s (Szatkowski & McNeill, 2015) and remain twice as high as in the general population (Royal College of Physicians & Royal College of Psychiatrists, 2013). Among mental health patients, smoking contributes to reduced life expectancy (Royal College of Physicians & Royal College of Psychiatrists, 2013) and interferes with the metabolism of pharmacotherapy: smokers require higher doses of some psychiatric medication,. Simonavicius et al / Journal of Substance Abuse Treatment 80 (2017) 37–44
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