Smoking and mental health - NCSCT

Smoking cessation interventions for individuals with mental disorders 5
To address patient smoking:
• one-to-one sessions provided on Merton wards
• every user of Merton services given a physical health screen that addresses
smoking and considers healthier alternatives
• six inpatient/ward-based clinics established (running twice weekly)
• six community-based clinics established (running twice weekly)
• personalised diaries for smoking cessation designed
• local promotional material designed
• carers involved through information session at carers meeting.
Stop smoking and
physical health
lead recruited
To address staff attitudes:
• care coordinators and registered nurses given a one-hour, level one smoking
cessation training
• workshops on smoking cessation conducted quarterly to provide staff with
opportunities to further develop skills
• roadshow conducted in staff canteen to raise awareness
• regular meeting with community outreach team to provide information, support
and treatment services.
To address procedural and policy barriers:
• service policy guidelines and pathways towards treatment in line with gold
standard service structures created
• commitment of all consultants pledged for new policy guidelines
• up-to-date records of smoking status on the trust electronic system maintained
to enable clear referral pathways.
Fig 5.1 Steps along the smoking treatment pathway.
for up to 4 weeks thereafter. Over 400 healthcare professionals (95% of frontline
staff) were trained to deliver interventions, and 180 patients accessed the service,
most of whom achieved assisted reduction. The number of patients successfully
quitting per quarter totalled 38 after 18 months of the specialist adviser being in
post. The greatest challenges were perceived to be related to staff attitudes
reflecting reluctant engagement with smoking cessation interventions for patients
with SMI, and to the development of adequate pathways including prescriptions
and management of pharmacotherapy.
5.6.2 Nottingham, UK
This project, part of a series of pilot projects funded by the Department of Health
to address tobacco-related inequalities, aimed to develop, implement and appraise
a tailored tobacco dependence service in mental health settings 101 (Fig 5.2). It also
aimed to address barriers to sustainable implementation by addressing knowledge
gaps, common misconceptions and more complex systemic issues relating to the
‘smoking culture’ in mental health settings, to develop instruments and materials
suitable to be integrated in care pathways, and to improve collaboration with the
local NHS SSS in the context of an integrative service model. The project was
© Royal College of Physicians 2013 101