Non-smoking programmes useful in psychiatric treatment

Psychiatric patients who took part in a smoking-cessation programme while they were in the hospital for treatment of mental illness were more likely to quit smoking and less likely to be hospitalised again for mental illness, a new study shows.
The findings challenge a common belief among mental-health experts that smoking is a useful tool in treating some psychiatric patients. For example, cigarettes may be used as part of a reward system or doctors may sometimes smoke with patients as a way of creating a connection, said Judith Prochaska, an associate professor at the Stanford University School of Medicine.
The study
Prochaska
and her colleagues studied 224 patients at a smoke-free psychiatric hospital in California. All the patients smoked at least five cigarettes a day prior to being admitted to the hospital. The patients had a range of mental-health conditions, including depression, bipolar disorder and schizophrenia. Three-quarters were suicidal. All of the patients were offered nicotine patches or gum during their hospitalisation.
The patients were divided into two groups. One group took part in a smoking-cessation programme while a control group received usual care. Patients in the control group were given a pamphlet about the hazards of smoking, along with information on how to quit.
The patients in the smoking-cessation program completed a computer-assisted programme with individualised feedback, received a print manual, met for 15 to 30 minutes with a counsellor and were offered a 10-week supply of nicotine patches if they decided they wanted to quit smoking.
The computer-assisted programme was repeated three and six months after patients left the hospital to support patients who wanted to quit smoking, according to the study, which was published online Aug. 15 in the American Journal of Public Health.
Results of the study
Eighteen months after leaving the hospital, 20% of those in the treatment group had quit smoking, compared with 7.7% of those in the control group. 44% of patients in the treatment group and 56% of those in the control group had been readmitted to the hospital.
The findings show that helping patients quit smoking did not harm their mental-health recovery and may have even improved it, Prochaska said.
"I think some of the therapeutic contact that addressed participants' tobacco dependence, and supported them with this major health goal, may have generalised to them feeling better about their mental-health condition," Prochaska said in a Stanford news release.