Smoking and mental health - NCSCT

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Smoking and mental health 8.8 Summary > The NHS spends approximately £720m per annum in primary and secondary care treating smoking-related disease in people with mental disorders. > These costs arise from an annual estimated 2.6 million avoidable hospital admissions, 3.1 million GP consultations and 18.8 million prescriptions. > The majority of these service costs arise from people diagnosed with anxiety and/or depression. > Smoking increases psychotropic drug costs in the UK by up to £40m per annum. > Achieving cessation in 25%, 50% and 100% of people with mental disorders would respectively result in a gain of 5.5 million, 11 million and 22 million undiscounted life-years in the UK. At 3.5% discounting, the corresponding figures are 1.4, 2.7 and 5.4 million life-years gained. > Harm reduction through lifelong substitution with medicinal nicotine is highly cost-effective when compared with continuing smoking, at around £8,000 per QALY gained for lifetime nicotine patch use and £3,600 per QALY for inhalators. > Addressing the high prevalence of smoking in people with mental disorders offers the potential to realise substantial cost savings to the NHS, as well as benefits in quantity and quality of life. References 1 Cyhlarova E, McCulloch A, McGuffin P, Wykes T. Economic burden of mental illness cannot be tackled without research investment. London: Mental Health Foundation, 2010. 2 Centre for Mental Health. The economic and social costs of mental health problems in 2009/10. London: Centre for Mental Health, 2010. 3 Department of Health. Departmental Report 2009: The Health and Personal Social Services Programmes. www.official-documents.gov.uk/document/cm75/7593/7593.pdf [Accessed 12 November 2012] 4 Allender S, Balakrishnan R, Scarborough P, al. The burden of smoking-related ill health in the UK. Tobacco Control 2009;18:262–7. 5 Callum C, White P. Tobacco in London: The preventable burden. London: SmokeFree London and The London Health Observatory, 2004. 6 Britton J. ABC of Smoking Cessation. London: Blackwell, 2004. 7 Bloom BS, et al. Usefulness of US cost-of-illness studies in healthcare decision making. PharmacoEconomics 2001;19:207–13. 8 Benichou J. A review of adjusted estimators of attributable risk. Statistical Methods in Medical Research 2001;10:195–216. 9 Levin ML. The occurrence of lung cancer in man. Acta Unio Internationalis Contra Cancrum 1953;9:531–41. 10 The NHS Information Centre. Lifestyles Statistics, Statistics on Smoking: England, 2010. London: NHA Information Centre, 2010. 178 © Royal College of Physicians 2013
The economic cost of smoking in people with mental disorders 8 11 Twigg L, Moon, G, Walker S. The Smoking Epidemic in England. London: Health Development Agency, 2004. 12 Phillips CJ, Bloodworth A. Cost of Smoking to the NHS in Wales. Swansea: Ashwales, 2009. 13 Osborn DP, Levy G, Nazareth I, et al. Relative risk of cardiovascular and cancer mortality in people with severe mental illness from the United Kingdom’s General Practice Rsearch Database. Archives of General Psychiatry 2007;64:242–9. 14 Wald NJ, Hackshaw AK. Cigarette smoking: an epidemiological overview. British Medical Bulletin 1996;52:3–11. 15 Hughes A, Atkinson H. Choosing Health in the South East: Smoking 2005. Oxford: South East Public Health Observatory (SEPHO). 16 Department of Health. Health Profile of England 2007. London: Department of Health (Health Improvement directorate, Analytical Team Monitoring Unit), 2007. 17 Hospital Episodes Statistics (HES). Hospital Episodes Statistics: Primary diagnosis. 2011. www.hesonline.org.uk. 18 The NHS Wales Informatics Service (NWIS). Health Solutions Wales, PEDW Statistics – 200910. Annual PEDW Data Tables 2011. www.infoandstats.wales.nhs.uk/page.cfm?orgid= 869&pid=41010&subjectlist=Principal+Diagnosis+%284+character+detail%29&patient coverlist=0&period=2009&keyword=&action=Search. 19 ISD Scotland. Inpatient and Day Case Activity, Hospital Care, 2011. www.isdscotland.org/ Health-Topics/Hospital-Care/Inpatient-and-Day-Case-Activity [Accessed 12 November 2012] 20 Health and Social Care in Northern Ireland. Northern Ireland Hospital Statistics: Inpatient and Day Case Activity (2010/11). www.dhsspsni.gov.uk/index/stats_research/hospitalstats/inpatients.htm [Accessed 19 November 2012] 21 Department of Health. Payment by Results Finance and Costing Team, Reference Costs Collection Guidance 2009–10. London: DH, 2010. 22 Department of Health. NHS reference costs 2009–2010. London: DH, 2011. 23 Department of Health. National Schedule of Reference Costs Year: ‘2009–10’ – NHS Trusts HRG Data. NHS reference costs 2009–2010. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/ DH_123459 [Accessed 6 December 2012] 24 Hippisley-Cox J, Vinogradova Y. Trends in Consultation Rates in General Practice 1995 to 2008: Analysis of the QResearch® database. Final Report to the NHS Information Centre and Department of Health. London: The NHS Information Centre, 2009. 25 The National Audit Office. Prescribing Costs in Primary Care. London: The Stationery Office, 2007. 26 The NHS Information Centre. Prescribing and Primary Care Services, Prescriptions Dispensed in the Community: England, Statistics for 2000 to 2010. London: The Health and Social Care Information Centre, 2011. 27 Curtis L. Unit Costs of Health and Social Care 2010. Kent: Personal Social Services Research Unit: 2010. 28 Office For National Statistics (ONS), Statistical Bulletin: Annual Mid-year Population Estimates, 2010. Newport: ONS, 2011. 29 Welsh Government. NHS Outpatient Activity. Health and care statistics 2011. wales.gov.uk/topics/statistics/theme/health/nhs-outpatient/;jsessionid= T2J0T60MJGZxTJtRWptr5bNTD7YpSNKGKm2WkhNvthBF0L8LCQhn!- 728126835?lang=en [Accessed 12 November 2012] 30 ISD Scotland. Outpatient Activity, Hospital Care, 2011. www.isdscotland.org/Health- Topics/Hospital-Care/Outpatient-Activity [6 December 2012] © Royal College of Physicians 2013 179
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PDF not for circulation Smoking and
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Contents Members of the Tobacco Adv
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Contents 4.4.3 Attention deficit hy
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Contents 6.4.3 Staff knowledge 122
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Contents 10.5 Tobacco policy and me
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Contributors Anthony Aclet - Specia
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Contributors Jill Williams - Associ
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1 Mental disorders 1.1 What is a me
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Mental disorders 1 1.3 Common menta
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Mental disorders 1 1.4.4 Somatisati
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Mental disorders 1 In addition to s
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Mental disorders 1 not diagnosed un
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Mental disorders 1 Similar to many
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Mental disorders 1 12 Chang CK, Hay
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Mental disorders 1 52 Young S, Toon
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Smoking among people with mental di
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Smoking cessation interventions for
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6 Population strategies to prevent
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Population strategies to prevent sm
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Smoking and mental health - NCSCT

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