Abstract
BackgroundSmoking rates, and associated negative health outcomes, are disproportionately high among people with mental illness compared to the general population. Smoke-free policies within mental health hospitals can positively impact on patients’ motivation and self-efficacy to address their smoking. However, without post-discharge support, preadmission smoking behaviours typically resume. This protocol describes a randomised controlled trial that aims to assess the efficacy of linking mental health inpatients to community-based smoking cessation supports upon discharge as a means of reducing smoking prevalence.Methods/DesignEight hundred participants with acute mental illness will be recruited into the randomised controlled trial whilst inpatients at one of four psychiatric inpatient facilities in the state of New South Wales, Australia. After completing a baseline interview, participants will be randomly allocated to receive either: ‘Supported Care’, a multimodal smoking cessation intervention; or ‘Normal Care’, consisting of existing hospital care only. The ‘Supported Care’ intervention will consist of a brief motivational interview and a package of self-help material for abstaining from smoking whilst in hospital, and, following discharge, 16 weeks of motivational telephone-based counselling, 12 weeks of free nicotine replacement therapy, and a referral to the Quitline. Data will be collected at 1, 6 and 12 months post-discharge via computer-assisted telephone interview. The primary outcomes are abstinence from smoking (7-day point prevalence and prolonged cessation), and secondary outcomes comprise daily cigarette consumption, nicotine dependence, quit attempts, and readiness to change smoking behaviour.DiscussionIf shown to be effective, the study will provide evidence in support of systemic changes in the provision of smoking cessation care to patients following discharge from psychiatric inpatient facilities.Trial registrationAustralian New Zealand Clinical Trials Registry ANZTCN: ACTRN12612001042831. Date registered: 28 September 2012.
Highlights
Smoking rates, and associated negative health outcomes, are disproportionately high among people with mental illness compared to the general population
Based on the findings of these previous studies, the objective of this study is to conduct a randomised controlled trial to test the effectiveness of a multi-modal smoking cessation intervention, initiated within mental health inpatient facilities for all smokers and continued post-discharge, on 12-month post-discharge smoking cessation rates
Participants will be recruited as inpatients at one of four acute mental health facilities within one Local Health District in New South Wales, Australia
Summary
Associated negative health outcomes, are disproportionately high among people with mental illness compared to the general population. Without post-discharge support, preadmission smoking behaviours typically resume. This protocol describes a randomised controlled trial that aims to assess the efficacy of linking mental health inpatients to community-based smoking cessation supports upon discharge as a means of reducing smoking prevalence. For smokers in the general population [12,13] and for those with a mental illness [14,15] multimodal smoking cessation interventions, utilising both pharmacological interventions (such as nicotine replacement therapy (NRT)). Psychosocial supports (such as behavioural counselling and self-help materials), have demonstrated efficacy in increasing the likelihood of quitting successfully. Neither making a quit attempt nor successfully ceasing smoking has been found to negatively impact on [14], and may even improve [19,20,21,22], psychiatric health
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