Smoking and mental health - NCSCT

Smoking among people with mental disorders 2
2.10 Delivery of smoking cessation interventions
Brief smoking cessation advice delivered during routine general practice
consultations has been shown to be effective in increasing cessation rates
in the general population, 27 and is one of the most cost-effective means to reduce
the burden of smoking. 28 Similarly, the use of NRT, 29 bupropion 30
or varenicline 31 significantly increases the chances of a quit attempt succeeding.
THIN data demonstrate that, after taking into account differences in age, sex,
socioeconomic status and a history of smoking-related chronic disease, smokers
with some mental disorders are generally (and in most categories, significantly)
more likely than the general population of smokers to have had delivery of
advice to quit smoking during the past year recorded in their medical notes 32
(Fig 2.6). Similar findings applied to prescribing of smoking cessation
medications, which was also significantly more likely to occur in most mental
disorder diagnostic and medication use groups than in smokers without mental
disorders (Fig 2.7).
Although these differences probably reflect in large part the effect of the
recently-introduced QOF incentive for GPs to offer smoking cessation advice and
support to smokers with certain mental disorders and the eligibility of many
patients with mental disorders for free prescriptions, these findings indicate
Smokers advised to quit (%)
75
65
55
45
35
25
All smokers
Smokers with no recorded mental
health diagnosis or prescription
Smokers with a diagnosis
of 1+ specific conditions
Schizophrenia, schizotypal
and delusional disorders
Bipolar affective disorder
Depression
Neurotic, stress-related
and somatoform disorders
Eating disorders
Specific personality disorders
Hyperkinetic dosorders,
including ADHD
Prescribed 1+
psychoactive medication
Antipsychotic
Lithium (antimanic)
Antidepressant
Anxiolytic
Fig 2.6 The proportion of smokers advised to quit according to mental
disorders and medication use (The Health Improvement Network (THIN)
data 6 ). ADHD, attention deficit hyperactivity disorder.
© Royal College of Physicians 2013 33