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Jella TK, Cwalina TB, Vallier HA. Concurrent Mental Illness and Financial Barriers to Mental Health Care Among a Nationally Representative Sample of Orthopaedic Trauma Survivors. J Orthop Trauma 2022; 36:665-673. [PMID: 36399680 DOI: 10.1097/bot.0000000000002433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To understand prevalence and factors associated with concurrent mental illness and financial barriers to mental health care after orthopaedic trauma. DESIGN This is a retrospective, cross-sectional study. SETTING Interview-based survey was conducted across representative sample of 30,000 US households. PATIENTS/PARTICIPANTS The study included 2,309 survey respondents reporting a fracture over the past 3 months, between 2004 and 2017. INTERVENTION Screening for financial barriers to mental health care. MAIN OUTCOME MEASUREMENTS Prevalence and factors associated with concurrent mental illness and financial barriers to mental health care based on sociodemographic and injury characteristics were the main outcome measurements. RESULTS Of the 2309 orthopaedic trauma survivors included in our analysis, 203 patients [7.8%, 95% confidence interval (CI): 6.4%-9.2%] were determined to experience severe mental illness, of whom 54 (25.3%, 95% CI: 18.0%-32.6%) and 86 (40.9%, 95% CI: 31.5%-50.2%) reported financial barriers to counseling and pharmacotherapy, respectively. Factors associated with concurrent severe mental illness and cost barriers to care were 45 to 64 years of age [adjusted odds ratios (AOR) 5.1, 95% CI: 1.7-15, P = 0.004], income below 200% of the Federal Poverty Threshold (AOR 2.5, 95% CI: 1.2-5.3, P = 0.012), and unemployment at the time of injury (AOR 3.9, 95% CI: 1.4-11, P = 0.009). CONCLUSIONS Approximately one half of orthopaedic trauma survivors with severe mental illness face financial barriers to some form of mental health services. Younger, minority, and low socioeconomic status patients are most affected. These data suggest the presence of postdiagnosis disparities in mental health access that may be improved through direct provision and subsidization of integrated mental health support services for high-risk populations. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Tarun K Jella
- Case Western Reserve University, Department of Orthopaedic Surgery, Cleveland, OH
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Evins AE, Cather C, Maravic MC, Reyering S, Pachas GN, Thorndike AN, Levy DE, Fung V, Fischer MA, Schnitzer K, Pratt S, Fetters MD, Deeb B, Potter K, Schoenfeld DA. A Pragmatic Cluster-Randomized Trial of Provider Education and Community Health Worker Support for Tobacco Cessation. Psychiatr Serv 2022; 74:365-373. [PMID: 36349498 DOI: 10.1176/appi.ps.20220187] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Individuals with serious mental illness have a high prevalence of tobacco use disorder and related early mortality but underutilize smoking cessation medication. The authors determined whether clinician-delivered education to primary care providers regarding safety, efficacy, and importance of cessation medication (provider education [PE]) alone or combined with community health worker (CHW) support would increase tobacco abstinence in this population, compared with usual care. METHODS All adult current tobacco smokers receiving psychiatric rehabilitation for serious mental illness through two community agencies in Greater Boston were eligible, regardless of readiness to quit smoking. Primary care clinics were cluster randomized to PE or usual care, with a nested, participant-level randomization to CHW or no CHW in PE-assigned clinics. The primary outcome was blindly assessed, biochemically verified tobacco abstinence at year 2. RESULTS Overall, 1,010 eligible participants were enrolled. PE was delivered to providers in 53 of 55 assigned clinics; 220 of 336 CHW-assigned participants consented to CHW support. Year 2 abstinence rates were significantly higher among participants assigned to PE+CHW versus usual care (12% vs. 5%; adjusted odds ratio [AOR]=2.40, 95% confidence interval [CI]=1.20-4.79) or PE alone (12% vs. 7%; AOR=1.84, 95% CI=1.04-3.24). No effect of PE alone on abstinence was detected. Compared with participants assigned to usual care, those assigned to PE+CHW had greater odds of varenicline use (OR=2.77, 95% CI=1.61-4.75), which was associated with higher year 2 abstinence (OR=1.97, 95% CI=1.16-3.33). CONCLUSIONS Combined PE and CHW tobacco cessation support increased tobacco abstinence rates among adults with serious mental illness.
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Affiliation(s)
- A Eden Evins
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Corinne Cather
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Melissa Culhane Maravic
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Sally Reyering
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Gladys N Pachas
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Anne N Thorndike
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Douglas E Levy
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Vicki Fung
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Michael A Fischer
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Kristina Schnitzer
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Sarah Pratt
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Michael D Fetters
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Bianca Deeb
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - Kevin Potter
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
| | - David A Schoenfeld
- Massachusetts General Hospital, Boston; Harvard Medical School, Boston (Evins, Cather, Pachas, Thorndike, Levy, Fung, Potter, Schoenfeld); Bay Cove Human Services, Boston (Reyering, Deeb); Boston Medical Center, Boston University School of Medicine, Boston (Fischer); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire (Pratt); Mixed Methods Research Program, Department of Family Medicine, University of Michigan, Ann Arbor (Fetters)
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Pemovska T, Jovanović N. Physical health of individuals with psychosis - a mixed method study. Int Rev Psychiatry 2022; 34:827-836. [PMID: 36645188 DOI: 10.1080/09540261.2022.2151341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
People with psychosis have poorer physical health than the general population and this aspect of care delivery has largely been neglected. The IMPULSE trial (ISRCTN 11913964) investigated a psychosocial intervention prompting people with psychosis to discuss their physical health concerns with mental health clinicians. This mixed-method study explored a series of clinical meetings over 6 months to understand how physical health is discussed, what actions are taken, and if these translated into benefits for the participating individuals with psychosis. 221 individuals with psychosis were included, attending 847 clinical meetings over 6 months. Results show that, when prompted, most participants (54%) took up the opportunity to discuss their physical health at least once. These individuals were keen to make changes such as adopt healthy diet, stop smoking, lose weight, etc. Despite taking steps to achieve these goals, after 6 months no improvement was detected in subjective satisfaction with physical health, severity of physical health problems or satisfaction with services. Adopting healthier lifestyle behaviours is difficult even in motivated individuals. Future research is needed to determine innovative approaches to promote lifestyle change in individuals with psychosis.
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Affiliation(s)
- Tamara Pemovska
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.,NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Nikolina Jovanović
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
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Badekar A, Rajalu BM, Muliyala KP, Sharma P, Chand PK, Murthy P. Prevalence and severity of tobacco use and access to tobacco cessation among tertiary care psychiatric in-patients in India. Indian J Psychiatry 2022; 64:572-578. [PMID: 36714672 PMCID: PMC9881721 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_405_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 09/20/2022] [Accepted: 10/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background Rates of smoking in persons with mental illness are reported to be two times higher than those without mental illness in developed countries. We aimed to examine the prevalence and severity of tobacco use, and access to tobacco cessation services among tertiary care psychiatric in-patients in India. Methods In this cross-sectional study, 500 consecutive adult in-patients in tertiary care with ICD 10 diagnoses, F20-59, were administered a sociodemographic and clinical proforma, Clinical Global Impression-Severity scale, Fagerstrom Test for Nicotine Dependence, Tobacco Craving Questionnaire, Reasons for quitting questionnaire, and Smoke Scale-Adults. Urine cotinine levels were estimated in the last 100 patients. Details of tobacco use and cessation interventions provided were obtained. Results Overall prevalence of current tobacco use was 34.00%; 34.3%, 32.6%, 43.6%, and 16.7% in patients of F20-29, F30-39, F40-49, and F50-59 categories, respectively. Males used tobacco products at a significantly higher rate (44.85% vs. 17.58% in females) and were highly dependent. Smokeless tobacco use was reported in 20.5% and 18% of female patients with F20-29 and F30-39 diagnoses, respectively. More than half of the tobacco users were not asked about tobacco use and 89.4% of the users were provided no prior assistance for cessation at the time of assessment. Urinary cotinine levels were significantly greater for those who use smokeless forms than smokers or dual users. Conclusions Nearly a third of psychiatric in-patients are current users of tobacco. Moderate to severe tobacco dependence was observed across psychiatric diagnoses. The assessment and interventions provided were suboptimal.
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Affiliation(s)
- Amol Badekar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Banu Manickam Rajalu
- Department of Nursing, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Krishna Prasad Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Priyamvada Sharma
- Department of Clinical Pharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Prabhat Kumar Chand
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
- Department of Director, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Perman-Howe PR, McNeill A, Brose LS, Tildy BE, Langley TE, Robson D. The Effect of Tobacco Control Mass Media Campaigns on Smoking-Related Behavior Among People With Mental Illness: A Systematic Literature Review. Nicotine Tob Res 2022; 24:1695-1704. [PMID: 35358321 PMCID: PMC9597075 DOI: 10.1093/ntr/ntac079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Tobacco control mass media campaigns (MMCs) can be effective generally, but little is known about their effects among people with mental illness. The objectives of this study were to systematically review: (1) Whether tobacco control MMCs affect smoking-related outcomes among people with mental illness. (2) Cost-effectiveness. AIMS AND METHODS Data sources: MEDLINE, Embase, PsycInfo, Web of Science, CINAHL, the Cochrane Library (searched March 2021), reference lists of included articles and relevant systematic reviews. Study eligibility criteria: Population: Adults with mental illness and experience of smoking tobacco and/or using other nicotine-containing products. Intervention/exposure: Tobacco control MMC messages. Comparator: No exposure, other tobacco control intervention(s), no comparator. Primary outcome: Changes in quitting behaviors. Study design: All primary research. Quantitative data were appraised using the EPHPP tool, qualitative data using CASP's Studies Checklist. Data were synthesized narratively. RESULTS Eight studies were included, seven were at high risk of bias. There was inconclusive evidence of the effect of MMCs on quit attempts and intentions to quit among people with mental illness. Increasing advertisement exposure did not increase quit attempts or intentions to quit among those with mental illness, however, increased exposure to an advertisement that addressed smoking and mental health did. None of the studies assessed cost-effectiveness. CONCLUSIONS Findings should be interpreted with caution as data are limited and of low or moderate quality. There is evidence to suggest that tobacco control MMCs have limited impact on those with mental illness, although campaigns that are specific to smoking and mental health may be effective. IMPLICATIONS There is a paucity of good-quality evidence of the effect of tobacco control MMC messages among people with mental illness. Careful consideration should be given to the design of future studies that evaluate MMCs in order to minimize the risk of bias, establish causality, and ensure the findings reflect real-world implementation. Further research should examine the need for MMC messages that address mental health.
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Affiliation(s)
| | - Ann McNeill
- Addictions Department, King’s College London, London, UK
| | - Leonie S Brose
- Addictions Department, King’s College London, London, UK
| | | | - Tessa E Langley
- University of Nottingham, School of Medicine, Nottingham, UK
| | - Debbie Robson
- Addictions Department, King’s College London, London, UK
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Goodwin RD, Shevorykin A, Carl E, Budney AJ, Rivard C, Wu M, McClure EA, Hyland A, Sheffer CE. Daily Cannabis Use Is a Barrier to Tobacco Cessation Among Tobacco Quitline Callers at 7-Month Follow-up. Nicotine Tob Res 2022; 24:1684-1688. [PMID: 35417562 PMCID: PMC9759104 DOI: 10.1093/ntr/ntac096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/08/2022] [Accepted: 04/07/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Cannabis use is increasing among cigarette smokers in the United States. Prior studies suggest that cannabis use may be a barrier to smoking cessation. Yet, the extent to which this is the case among adults seeking to quit tobacco use remains unclear. Tobacco quitlines are the most common provider of no-cost treatment for adults who use smoke in the United States. This study investigated the association between cannabis use and smoking cessation outcomes among quitline callers. AIMS AND METHODS Participants included callers to the New York State Smokers' Quitline, who were seeking to quit smoking cigarettes and were contacted for outcome assessment 7 months after intake. Thirty-day point prevalence abstinence rates were calculated and compared among cannabis use groups, based on frequency of past-30-day cannabis use at baseline (none: 0 days, occasional: 1-9 days, regular: 10-19 days, and daily: 20-30 days). RESULTS Approximately 8.3% (n = 283) of participants (n = 3396) reported past-30-day cannabis use at baseline. Callers with daily cannabis use (20-30 days per month) had significantly lower odds of 30-day abstinence, relative to those who did not use cannabis (odds ratio = 0.5; 95% confidence interval [0.3, 0.9]). CONCLUSIONS Daily cannabis use appears to be associated with poorer smoking cessation treatment outcomes among adults seeking to quit smoking cigarettes via a quitline. Because quitlines are among the most accessible, affordable, and frequently utilized community-based treatments available in the United States, and the prevalence of cannabis use is increasing among cigarette smokers, detailed inquiry into cannabis use might enhance cigarette smoking cessation outcomes. IMPLICATIONS Quitlines are free of cost and accessible to millions of smokers in the United States. The current study found an inverse relationship between daily cannabis use at baseline and 30-day abstinence from cigarette smoking at 7-month follow-up among New York State Smokers' Quitline callers. Findings suggest that daily cannabis use may be a barrier to smoking cessation and sustained abstinence among those seeking help to stop smoking cigarettes.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alina Shevorykin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ellen Carl
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alan J Budney
- Department of Psychiatry, Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Cheryl Rivard
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Melody Wu
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Technology Applications Center for Healthful Lifestyles (TACHL), South Carolina Center of Economic Excellence, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Sigara Kullanma Durumunun Aile Içi Fonksiyonlara Etkisi. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1147330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Aim: Family is the most natural environment where people can meet their needs of love, compassion, affection and care for mental and physical health. In this study, we aim to investigate the relation between smoking and family functions.
Material and Method: Ninety seven patients between 18-60 years age who were admitted to the Ankara Training and Research Hospital, live with at least one family member and agreed to participate in the study were included in this study. Cross-sectional, observational and analytic methods were applied. The recorded data of the participants were as follows: age, sex, occupation, marital status, education level, the family members whom living with, the status of smoking at home, chronic diseases and current medication. McMaster Model of Family Functioning (MMFF) and Fagerström Test for Nicotine Dependence (FTND) were used.
Results: Statistically significant differences between MMFF scores of smoking patients in the subscales of “Roles” and “Affective Involvement” were found (p=0.004, p= 0.002, respectively). We have seen in the subscale of “Problem Solving” that single members were negatively affected (p=0.033). The negative effects of smoking were found to be decreasing by age in the “Communication” subscale (p=0.002). The “Roles” subscale was observed to be negatively disturbed in the group of smokers with chronic diseases(p=0,050). We also found that being single and having a chronic disease negatively affected “Affective Responsiveness” subscale (p=0.050, p=0.020, respectively).
Conclusion: Smoking affects the family functions negatively. Thus, the fight against smoking might be thought to make a favorable effect on the family functions.
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Lima DR, Guimaraes-Pereira BBS, Mannes ZL, Carvalho CFC, Loreto AR, Davanso LC, Frallonardo FP, Ismael F, de Andrade AG, Castaldelli-Maia JM. The effect of a real-world intervention for smoking cessation in Adults with and without comorbid psychiatric and substance use disorders: A one-year follow-up study. Psychiatry Res 2022; 315:114722. [PMID: 35841703 PMCID: PMC11055494 DOI: 10.1016/j.psychres.2022.114722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
This study evaluated short-term abstinence and prolonged abstinence following a real-world intervention for smoking cessation in a sample of 1,213 adults with nicotine dependence only (ND), nicotine dependence and past history of another substance use disorder (ND-SUD), nicotine dependence and a non-substance use mental health disorder (ND-MD), or nicotine dependence and comorbid substance use disorder and mental health disorder (ND-SUMD). Participants received six sessions of group Cognitive Behavioral Therapy (CBT) and pharmacotherapy. Abstinence was assessed following completion of treatment and at 12-month follow-up. Logistic regression and survival analyses were performed. Participants who were lost to follow-up were included as censored and baseline differences were used as covariates in multivariate analyses. Rates of short-term abstinence and prolonged abstinence were significantly different between ND and ND-SUMD (20.9% versus 36.5%; 14.9% versus 22.4%, respectively). Among participants with follow-up, 37.7% were abstinent at 12-month. Diagnostic group was not associated with abstinence at 12-month follow-up after adjusting for nicotine dependence severity, which was associated with lower likelihood of abstinence (HR=1.11;95%CI:1.03-1.19). CBT plus pharmacotherapy had a positive effect on smoking cessation among the participants in this study. Special attention should be given to adults with more severe nicotine dependence and comorbid psychiatric and substance use disorders.
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Affiliation(s)
- Danielle Ruiz Lima
- Grupo Interdisciplinar de Estudos de Alcool e outras Drogas (GREA), Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | | | - Zachary L Mannes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, U.S., 10032
| | | | - Aline Rodrigues Loreto
- ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil
| | - Lucas Carvalho Davanso
- Department of Neuroscience, Medical School, ABC Foundation, Santo André - SP, 09060-870, Santo Andre, SP, BR
| | - Fernanda Piotto Frallonardo
- ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil; Universidade Municipal de São Caetano do Sul - Campus Centro, São Caetano do Sul, Sao Paulo, 09521-160, Brazil
| | - Flavia Ismael
- ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil; Universidade Municipal de São Caetano do Sul - Campus Centro, São Caetano do Sul, Sao Paulo, 09521-160, Brazil
| | - Arthur Guerra de Andrade
- Grupo Interdisciplinar de Estudos de Alcool e outras Drogas (GREA), Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR; Department of Neuroscience, Medical School, ABC Foundation, Santo André - SP, 09060-870, Santo Andre, SP, BR; ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil
| | - Joao Mauricio Castaldelli-Maia
- Grupo Interdisciplinar de Estudos de Alcool e outras Drogas (GREA), Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR; Department of Neuroscience, Medical School, ABC Foundation, Santo André - SP, 09060-870, Santo Andre, SP, BR; ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, U.S., 10032
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Morar T, Robertson L. Smoking cessation among people with mental illness: A South African perspective. S Afr Fam Pract (2004) 2022; 64:e1-e9. [PMID: 36073100 PMCID: PMC9453116 DOI: 10.4102/safp.v64i1.5489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/31/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022] Open
Abstract
Tobacco use is recognised as a serious, worldwide public health concern. Smoking cessation is of great interest across a wide range of medical specialities, including family medicine. However, smoking cessation among people with mental illness (PWMI) has attracted scant attention in South African literature. This is despite PWMI suffering disproportionately from the damages of tobacco. The harms of smoking are not limited to physical health but extend to mental health. This article discusses the need for multifaceted smoking cessation treatments for PWMI in the public health sector, taking into consideration the prevalence and unique drivers of smoking in this population. A brief overview of patterns of tobacco use, associated harms and smoking cessation interventions in South Africa is given; all within the context of mental illness.
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Affiliation(s)
- Tejil Morar
- Department of Psychiatry, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg.
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60
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Olando Y, Mathai M, Kuria M, Njiri F, Huffman M. Effect of a group tobacco cessation behavioral intervention
among patients with mental illness in Kenya: Results from a
controlled clinical trial. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/152132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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61
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Nagawa CS, Wang B, Davis M, Pbert L, Cutrona SL, Lemon SC, Sadasivam RS. Examining pathways between family or peer factors and smoking cessation in a nationally representative US sample of adults with mental health conditions who smoke: a structural equation analysis. BMC Public Health 2022; 22:1566. [PMID: 35978318 PMCID: PMC9382825 DOI: 10.1186/s12889-022-13979-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Supportive family or peer behaviors positively impact smoking cessation in people with mental health problems who smoke. However, the limited understanding of the pathways through which family or peer factors impact quitting limits the development of effective support interventions. This study examined pathways through which family or peer views on tobacco use, family or peer smoking status, and rules against smoking in the home influenced quitting in adults with mental health problems who smoke. Methods We used data from the Population Assessment of Tobacco and Health Study, a national longitudinal survey. Baseline data were collected in 2015, and follow-up data in 2016. We included adults’ current smokers who had experienced two or more mental health symptoms in the past year (unweighted n = 4201). Structural equation modeling was used to test the relationships between family and peer factors, mediating factors, and smoking cessation. Results We found that having family or peers with negative views on tobacco use had a positive indirect effect on smoking cessation, mediated through the individual’s intention to quit (regression coefficient: 0.19) and the use of evidence-based approaches during their past year quit attempt (regression coefficient: 0.32). Having rules against smoking in the home (regression coefficient: 0.33) and having non-smoking family members or peers (regression coefficient: 0.11) had a positive indirect effect on smoking cessation, mediated through smoking behaviors (regression coefficient: 0.36). All paths were statistically significant (p < 0.01). The model explained 20% of the variability in smoking outcomes. Conclusion Family or peer-based cessation interventions that systematically increase intentions to quit and monitor smoking behavior may be able to assess the efficacy of family and peer support on quitting in people with mental health problems who smoke. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13979-z.
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Affiliation(s)
- Catherine S Nagawa
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Maryann Davis
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Lori Pbert
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Sarah L Cutrona
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.,Health Services Research & Development, Center of Innovation Edith Nurse Rogers Memorial Hospital Veterans Health Administration, Bedford, USA
| | - Stephenie C Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Rajani S Sadasivam
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.,Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
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62
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Han B, Tipperman D, Compton WM. Prevalence of Cigarette Smoking Among US Adults With Major Depression or Substance Use Disorders-Reply. JAMA 2022; 328:585-586. [PMID: 35943474 DOI: 10.1001/jama.2022.10855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Douglas Tipperman
- Substance Abuse and Mental Health Services Administration, Rockville, Maryland
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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63
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Newton H, Busch SH, Brunette MF, Maust DT, O'Malley AJ, Meara E. Innovations in Care Delivery for Patients With Serious Mental Illness Among Accountable Care Organizations. Psychiatr Serv 2022; 73:889-896. [PMID: 35378992 PMCID: PMC9349464 DOI: 10.1176/appi.ps.202000484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study examined whether and how organizations participating in accountable care organization (ACO) contracts integrate primary care and treatment for patients with serious mental illness. METHODS This study used responses to the 2017–2018 National Survey of ACOs (55% response rate) to measure ACO-reported use of three integrated care strategies: care manager to address physical health treatment coordination or nonmedical needs (e.g., job support and housing), patient registries to track physical health conditions, and primary care clinician colocated in a specialty mental health setting. Logistic regression was used to determine associations between ACO characteristics and strategy use. RESULTS Of 399 respondents who answered questions on integration, 303 (76%) reported using at least one integrated care strategy in at least one location. Use of care managers (defined by the respondent) was most common (N=281, 70%), followed by use of a patient registry (N=146, 37%) and colocation of a primary care clinician in a specialty mental health setting (N=118, 30%). Respondents reporting that their largest Medicaid contract or largest commercial contract included quality measures specific to serious mental illness (e.g., antipsychotic adherence) were more likely to use each integrated care delivery strategy. Self-reported use of three collaborative care strategies (care management, patient registry, or mental health consulting clinician) for treatment of depression or anxiety was associated with use of integrated primary care and treatment for serious mental illness. CONCLUSIONS In a national survey of ACOs, few respondents reported using either patient registries or primary care colocation to integrate primary care and treatment for serious mental illness.
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Affiliation(s)
- Helen Newton
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut (Newton, Busch); Department of Psychiatry (Brunette), Department of Biomedical Data Science (O'Malley), and Dartmouth Institute for Health Policy and Clinical Practice (O'Malley), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Bureau of Mental Health, New Hampshire Department of Health and Human Services, Concord (Brunette); Department of Psychiatry, University of Michigan School of Medicine, and Department of Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan (Maust); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, and National Bureau of Economic Research, Cambridge, Massachusetts (Meara)
| | - Susan H Busch
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut (Newton, Busch); Department of Psychiatry (Brunette), Department of Biomedical Data Science (O'Malley), and Dartmouth Institute for Health Policy and Clinical Practice (O'Malley), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Bureau of Mental Health, New Hampshire Department of Health and Human Services, Concord (Brunette); Department of Psychiatry, University of Michigan School of Medicine, and Department of Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan (Maust); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, and National Bureau of Economic Research, Cambridge, Massachusetts (Meara)
| | - Mary F Brunette
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut (Newton, Busch); Department of Psychiatry (Brunette), Department of Biomedical Data Science (O'Malley), and Dartmouth Institute for Health Policy and Clinical Practice (O'Malley), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Bureau of Mental Health, New Hampshire Department of Health and Human Services, Concord (Brunette); Department of Psychiatry, University of Michigan School of Medicine, and Department of Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan (Maust); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, and National Bureau of Economic Research, Cambridge, Massachusetts (Meara)
| | - Donovan T Maust
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut (Newton, Busch); Department of Psychiatry (Brunette), Department of Biomedical Data Science (O'Malley), and Dartmouth Institute for Health Policy and Clinical Practice (O'Malley), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Bureau of Mental Health, New Hampshire Department of Health and Human Services, Concord (Brunette); Department of Psychiatry, University of Michigan School of Medicine, and Department of Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan (Maust); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, and National Bureau of Economic Research, Cambridge, Massachusetts (Meara)
| | - A James O'Malley
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut (Newton, Busch); Department of Psychiatry (Brunette), Department of Biomedical Data Science (O'Malley), and Dartmouth Institute for Health Policy and Clinical Practice (O'Malley), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Bureau of Mental Health, New Hampshire Department of Health and Human Services, Concord (Brunette); Department of Psychiatry, University of Michigan School of Medicine, and Department of Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan (Maust); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, and National Bureau of Economic Research, Cambridge, Massachusetts (Meara)
| | - Ellen Meara
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut (Newton, Busch); Department of Psychiatry (Brunette), Department of Biomedical Data Science (O'Malley), and Dartmouth Institute for Health Policy and Clinical Practice (O'Malley), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Bureau of Mental Health, New Hampshire Department of Health and Human Services, Concord (Brunette); Department of Psychiatry, University of Michigan School of Medicine, and Department of Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan (Maust); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, and National Bureau of Economic Research, Cambridge, Massachusetts (Meara)
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64
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Regan C, Fehily C, Campbell E, Bowman J, Faulkner J, Oldmeadow C, Bartlem K. Clustering of chronic disease risks among people accessing community mental health services. Prev Med Rep 2022; 28:101870. [PMID: 35813396 PMCID: PMC9256721 DOI: 10.1016/j.pmedr.2022.101870] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/19/2022] [Accepted: 06/24/2022] [Indexed: 10/26/2022] Open
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Broughan J, McCombe G, Lim J, O'Keeffe D, Brown K, Clarke M, Corcoran C, Hanlon D, Kelly N, Lyne J, McGorry P, O' Brien S, O' Connor K, O' Mahony K, Scott S, Wycherley E, Cullen W. Keyworker mediated enhancement of physical health in patients with first episode psychosis: A feasibility/acceptability study. Early Interv Psychiatry 2022; 16:883-890. [PMID: 34716662 DOI: 10.1111/eip.13234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/08/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022]
Abstract
AIM Early intervention for people experiencing first episode psychosis is a priority, and keyworkers are vital to such services. However, keyworkers' roles in addressing first episode psychosis patients' physical health are under researched. This study addresses this knowledge gap by evaluating a keyworker-mediated intervention promoting physical health among first episode psychosis patients. METHODS The study was informed by the Medical Research Council's Framework for Complex Interventions to Improve Health. First episode psychosis participants were recruited from three Irish mental health services. The intervention was evaluated in terms of its feasibility/acceptability. RESULTS Feasibility outcomes were mixed (recruitment rate = 24/68 [35.3%]; retention rate = 18/24 [75%]). The baseline sample was predominantly male (M:F ratio = 13:6; Med age = 25 y; IQR = 23-42 y). Common health issues among participants included overweightness/obesity (n = 11) and substance use (smoking/alcohol consumption [n = 19]). Participants' initial health priorities included exercising more (n = 10), improving diet (n = 6), weight loss (n = 7) and using various health/healthcare services. The intervention's acceptability was evidenced by the appreciation participants had for physical health keyworkers' support, as well as the healthy lifestyle, which the intervention promoted. Acceptability was somewhat compromised by a low-recruitment rate, variable linkages between keyworkers and general practitioners (GPs) and COVID-19 restrictions. CONCLUSIONS Physical health-oriented keyworker interventions for first episode psychosis patients show promise and further evaluation of such initiatives is warranted. Future interventions should be mindful of participant recruitment challenges, strategies to enhance relationships between keyworkers and GPs, and if necessary, they should mitigate COVID-19 restrictions' impacts on care.
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Affiliation(s)
- John Broughan
- School of Medicine, University College Dublin, Dublin, Leinster, Ireland
| | - Geoff McCombe
- School of Medicine, University College Dublin, Dublin, Leinster, Ireland
| | - Jayleigh Lim
- School of Medicine, University College Dublin, Dublin, Leinster, Ireland
| | - Donal O'Keeffe
- DETECT Early Intervention in Psychosis Service, Dublin, Leinster, Ireland
| | | | - Mary Clarke
- School of Medicine, University College Dublin, Dublin, Leinster, Ireland.,DETECT Early Intervention in Psychosis Service, Dublin, Leinster, Ireland
| | - Ciarán Corcoran
- Longford Westmeath Mental Health Service, Health Service Executive, Dublin, Leinster, Ireland
| | - David Hanlon
- Health Service Executive, Dublin, Leinster, Ireland
| | - Ned Kelly
- Health Service Executive, Dublin, Leinster, Ireland
| | - John Lyne
- Royal College of Surgeons in Ireland, Dublin, Leinster, Ireland.,Wicklow Mental Health Services, Wicklow, Leinster, Ireland
| | - Patrick McGorry
- Center for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Orygen Youth Health, Parkville, VIC, Australia
| | | | - Karen O' Connor
- Cork University Hospital, Health Services Executive, Cork, Munster, Ireland
| | - Karen O' Mahony
- Cork Kerry Mental Health Services, Health Service Executive South, Munster, Ireland
| | - Seamus Scott
- Longford Westmeath Mental Health Service, Health Service Executive, Dublin, Leinster, Ireland
| | - Elizabeth Wycherley
- Cork Kerry Mental Health Services, Health Service Executive South, Munster, Ireland
| | - Walter Cullen
- School of Medicine, University College Dublin, Dublin, Leinster, Ireland
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Harlow AF, Stokes AC, Brooks DR, Benjamin EJ, Barrington-Trimis JL, Ross CS. e-Cigarette Use and Combustible Cigarette Smoking Initiation Among Youth: Accounting for Time-Varying Exposure and Time-Dependent Confounding. Epidemiology 2022; 33:523-532. [PMID: 35394965 PMCID: PMC9156560 DOI: 10.1097/ede.0000000000001491] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Youth e-cigarette use is associated with the initiation of combustible cigarette smoking, but prior studies have rarely accounted for time-varying measures of e-cigarette exposure or time-dependent confounding of e-cigarette use and smoking initiation. METHODS Using five waves of the Population Assessment of Tobacco and Health (2013-2019), we estimated marginal structural models with inverse probability of treatment and censoring weights to examine the association between time-varying e-cigarette initiation and subsequent cigarette smoking initiation among e-cigarette- and cigarette-naïve youth (12-17 years) at baseline. Time-dependent confounders used as predictors in inverse probability weights included tobacco-related attitudes or beliefs, mental health symptoms, substance use, and tobacco-marketing exposure. RESULTS Among 9,584 youth at baseline, those who initiated e-cigarettes were 2.4 times as likely to subsequently initiate cigarette smoking as youth who did not initiate e-cigarettes (risk ratio = 2.4, 95% confidence interval [CI] = 2.1, 2.7), after accounting for time-dependent confounding and selection bias. Among youth who initiated e-cigarettes, more frequent vaping was associated with greater risk of smoking initiation (risk ratio ≥3 days/month = 1.8, 95% CI = 1.4, 2.2; 1-2 days/month = 1.2; 95% CI = 0.93, 1.6 vs. 0 days/month). Weighted marginal structural model estimates were moderately attenuated compared with unweighted estimates adjusted for baseline-only confounders. At the US population level, we estimated over half a million youth initiated cigarette smoking because of prior e-cigarette use over follow-up. CONCLUSIONS The association between youth vaping and combustible cigarette smoking persisted after accounting for time-dependent confounding. We estimate that e-cigarette use accounts for a considerable share of cigarette initiation among US youth. See video abstract at, http://links.lww.com/EDE/B937.
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Affiliation(s)
- Alyssa F. Harlow
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
| | - Andrew C. Stokes
- Boston University School of Public Health, Department of Global Health, Boston, MA
| | - Daniel R. Brooks
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
| | - Emelia J. Benjamin
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
- Boston University School of Medicine, Department of Medicine, Boston, MA
| | | | - Craig S. Ross
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
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Japuntich SJ, Adkins-Hempel M, Lundtvedt C, Becker SJ, Helseth SA, Fu SS, Tidey J, Evins AE, Pratt R. Implementing Chronic Care Model Treatments for Cigarette Dependence in Community Mental Health Clinics. J Dual Diagn 2022; 18:153-164. [PMID: 35763554 PMCID: PMC9472099 DOI: 10.1080/15504263.2022.2090647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective: Tobacco use is rarely addressed in community mental healthcare settings, despite its high prevalence among people with serious mental illness. The aim of the current study was to gather stakeholder feedback regarding the feasibility of chronic care management strategies for tobacco dependence in community mental health centers (CMHCs). Chronic care strategies evaluated included the 5 As (Ask about tobacco use, Advise users of tobacco to quit, Assess interest in cessation, Assist with cessation, and Arrange for follow-up) and proactive telephone outreach (reaching out to all users of tobacco to offer connection to tobacco cessation treatment). Methods: Using a semi-structured interview guide informed by the Practical Robust Implementation and Sustainability Model, we conducted individual semi-structured interviews with providers, leaders, and clients across two CMHCs. Our objectives were to capture their attitudes toward smoking cessation treatment, two chronic care model interventions (i.e., proactive outreach, the 5 As), and to determine the infrastructure needed to implement such interventions in their CMHCs. Thematic analysis was conducted by two independent coders to uncover pertinent themes. Results: Participants (n = 20) included nine providers, six leaders, and five clients. Thematic analysis revealed three major themes: (1) characteristics of recipients, (2) characteristics of the intervention, and (3) infrastructure needed for implementation and sustainability. Providers, leaders, and clients all reported that tobacco cessation treatment was rarely provided in CMHCs and expressed an interest in such treatments becoming more available. The 5 As and proactive outreach were viewed as feasible and acceptable to deliver and receive. Providers, leaders, and clients wanted support to connect clients with smoking cessation treatment. Providers and leaders requested a range of implementation supports, including didactic trainings, decision aids, performance feedback, and coaching on evidence-based tobacco cessation treatments for people with serious mental illness. Clients requested tobacco cessation resources, such as a cessation counseling provided at the CMHC and prescriptions for cessation medication. Conclusions: CMHC providers, leaders, and clients are interested in making tobacco cessation services more widely accessible and available. The feedback gathered in this study can be used to inform the delivery and implementation of guideline-adherent tobacco dependence care in CMHCs.
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Affiliation(s)
- Sandra J. Japuntich
- Department of Clinical Pharmacology and Toxicology, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | | | - Carina Lundtvedt
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA
| | - Sara J. Becker
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- Department of Psychiatry and Human Behavior, the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sarah A. Helseth
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Steven S. Fu
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- VA HSR&D Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Jennifer Tidey
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- Department of Psychiatry and Human Behavior, the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - A. Eden Evins
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Psychiatry Department, Harvard Medical School, Boston, Massachusetts, USA
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
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68
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Schöttl SE, Niedermeier M, Kopp-Wilfling P, Frühauf A, Bichler CS, Edlinger M, Holzner B, Kopp M. Add-on exercise interventions for smoking cessation in people with mental illness: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2022; 14:115. [PMID: 35729669 PMCID: PMC9210718 DOI: 10.1186/s13102-022-00498-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/07/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Smoking is the most common substance use disorder among people with mental illness. In contrast to people without mental illness, among whom the proportion of smokers has declined in recent decades, the proportion of smokers among people with mental illness remains high. There is a growing body of literature suggesting the use of exercise interventions in combination with smoking cessation in people without mental illness, but to our knowledge the available studies on this treatment option in people with mental illness have not been systematically reviewed. Therefore, this systematic review and meta-analysis aims to assess the effectiveness of exercise interventions as an adjunctive treatment for smoking cessation in people with mental illness. METHODS Electronic databases (PubMed, Web of Science, PsycInfo, Sport Discus and Base) were searched for randomised controlled trials and prospective single-group studies that investigated exercise interventions in combination with smoking cessation programmes alone or in comparison with a control group in people with mental illness. A meta-analysis using the Mantel-Haenszel fixed-effect model was conducted to estimate the overall effect of treatment on smoking cessation (abstinence rate at the end of the intervention and at 6-month follow-up). RESULTS Six studies, five randomised controlled trials and one study with a prospective single-group design, were included in the systematic review and four randomised controlled trials were included in the meta-analysis. The meta-analysis found a significantly higher abstinence rate after additional exercise at the end of the intervention [risk ratio (RR) 1.48, 95% confidence interval (CI) 1.13-1.94], but not at the 6-month follow-up (RR 1.34, 95% CI 0.89-2.04). CONCLUSIONS Exercise appears to be an effective adjunctive therapy to temporarily increase abstinence rates in individuals with mental illness at the end of the intervention. However, due to the small number of included studies and some risk of bias in the included studies, the results should be treated with caution. Therefore, future studies with larger samples are needed to provide a more accurate estimate of the effect in people with mental illness. Registration The systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42020178630).
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Affiliation(s)
- Stefanie E. Schöttl
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
| | - Prisca Kopp-Wilfling
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry I, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Anika Frühauf
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
| | - Carina S. Bichler
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
| | - Monika Edlinger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry I, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Bernhard Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry I, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
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Néstor S, Carlos P, Cristina P, José MR, Ignacio B, Pilar S. TOBACCO USE DISORDER AND DUAL DISORDERS Joint statement by the Spanish Psychiatry Society and the Spanish Dual Disorders Society. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:77-138. [PMID: 35731182 PMCID: PMC11095114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Tobacco Use Disorder (TUD) is a health problem of the first order in the world population, affecting a vulnerable population, such as people with other mental disorders, whose morbidity and mortality are increased as a result.
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Affiliation(s)
- Szerman Néstor
- Instituto de Psiquiatría y Salud Mental, Hospital General Universitario Gregorio Marañón, Madrid, España. Miembro de la Sociedad Española de Patología Dual (SEPD)
| | - Parro Carlos
- Instituto de Psiquiatría y Salud Mental, Hospital General Universitario Gregorio Marañón, Madrid, España. Miembro de la Sociedad Española de Patología Dual (SEPD)
| | - Pinet Cristina
- Unidad Toxicomanías, Servicio de Psiquiatría, Hospital Sant Pau, Barcelona, España. Miembro de la Sociedad Española de Psiquiatría (SEP)
| | - Martínez-Raga José
- Departamento de Psiquiatría y Psicología Médica. Hospital Universitario Doctor Peset y Universitat de Valencia. Valencia, España. Miembro de la Sociedad Española de Patología Dual (SEPD)
| | - Basurte Ignacio
- Dirección médica de Psiquiatría y Salud Mental de la Clínica López Ibor. Madrid, España. Profesor vinculado de la Universidad Europea de Madrid. Madrid, España. Miembro de la Sociedad Española de Patología Dual (SEPD)
| | - Saiz Pilar
- Catedrática de Psiquiatría. Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Instituto de Investigación sanitaria del Principado de Asturias (ISPA), Servicio de Salud del Principado de Asturias (SESPA). Asturias, España. Miembro de la Sociedad Española de Psiquiatría (SEP)
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70
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Miles LW, Thatcher B, Thomas MC, Winters B. Treatment pearls: Management of physical healthcare needs in patients with mental illness. Nurse Pract 2022; 47:20-28. [PMID: 35604294 DOI: 10.1097/01.npr.0000829784.91687.8c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Clinicians caring for persons with mental illness should be aware of increased mortality, physical problems, and health disparities in this population. This article provides a brief overview of physical health problems in the context of mental illness as well as those related to psychotropic medications, and discusses strategies to manage treatment effectively.
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71
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Spanakis P, Peckham E, Young B, Heron P, Bailey D, Gilbody S. A systematic review of behavioural smoking cessation interventions for people with severe mental ill health-what works? Addiction 2022; 117:1526-1542. [PMID: 34697848 PMCID: PMC9298065 DOI: 10.1111/add.15724] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 10/08/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS People with severe mental ill health smoke more and suffer greater smoking-related morbidity and mortality. Little is known about the effectiveness of behavioural interventions for smoking cessation in this group. This review evaluated randomized controlled trial evidence to measure the effectiveness of behavioural smoking cessation interventions (both digital and non-digital) in people with severe mental ill health. DESIGN Systematic review and random-effects meta-analysis. We searched between inception and January 2020 in Medline, EMBASE, PsycINFO, CINAHL, Health Management Information Consortium and CENTRAL databases. SETTING AND PARTICIPANTS Randomized controlled trials (RCTs) assessing the effects of behavioural smoking cessation and reduction interventions in adults with severe mental ill health, conducted in any country, in either in-patient or community settings and published in English. MEASUREMENTS The primary outcome was biochemically verified smoking cessation. Smoking reduction and changes in mental health symptoms and body mass index (BMI) were included as secondary outcomes. Narrative data synthesis and meta-analysis were conducted and the quality of included studies was appraised using the risk of bias 2 (RoB2) tool. FINDINGS We included 12 individual studies (16 articles) involving 1861 participants. The first meta-analysis (three studies, 921 participants) demonstrated effectiveness of bespoke face-to-face interventions compared with usual care across all time-points [medium-term: relative risk (RR) = 2.29, 95% confidence interval (CI) = 1.38-3.81; long-term: RR = 1.58, 95% CI = 1.09-2.30]. The second (three studies, 275 participants) did not demonstrate any difference in effectiveness of bespoke digital on-line interventions compared with standard digital on-line interventions (medium-term: RR = 0.87, 95% CI = 0.17-4.46). A narrative overview revealed mixed results when comparing bespoke face-to-face interventions with other active interventions. The methodological quality of studies was mixed, with the majority having some concerns mainly around risk of selective reporting. CONCLUSIONS Face-to-face bespoke smoking cessation interventions for adults with severe mental ill health appear to be effective when compared with treatment as usual, but evidence is equivocal when compared with other active interventions. There is limited evidence comparing bespoke digital interventions with generic interventions, and we found no studies comparing them with usual treatment.
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Affiliation(s)
- Panagiotis Spanakis
- Department of Health Sciences and Closing the Gap NetworkUniversity of YorkYorkUK
| | - Emily Peckham
- Department of Health Sciences and Closing the Gap NetworkUniversity of YorkYorkUK
| | - Ben Young
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - Paul Heron
- Department of Health Sciences and Closing the Gap NetworkUniversity of YorkYorkUK
| | - Della Bailey
- Department of Health Sciences and Closing the Gap NetworkUniversity of YorkYorkUK
| | - Simon Gilbody
- Department of Health Sciences and Closing the Gap NetworkUniversity of YorkYorkUK,York Hull Medical SchoolUniversity of York, HeslingtonYorkUK
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72
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Friedman AS, Tam J, Busch SH. US Smoking Trends Among Young Adults with Serious Psychological Distress: 1997-2018. J Gen Intern Med 2022; 37:2110-2112. [PMID: 34378116 PMCID: PMC9198120 DOI: 10.1007/s11606-021-07013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/25/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Abigail S Friedman
- Department of Health Policy & Management, Yale School of Public Health, New Haven, CT, USA.
| | - Jamie Tam
- Department of Health Policy & Management, Yale School of Public Health, New Haven, CT, USA
| | - Susan H Busch
- Department of Health Policy & Management, Yale School of Public Health, New Haven, CT, USA
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73
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Fisher K, Weissinger G, O'Rorke R, Edwards E, Diamond G. Consumers With Serious Mental Illness Perspectives on Care Integration: Preparation for Integration. J Am Psychiatr Nurses Assoc 2022; 28:193-202. [PMID: 35546134 DOI: 10.1177/10783903221091974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Those with serious mental illness (SMI) experience poor health outcomes which may be addressed by the integration of mental health and primary care services. This integration could be enhanced by the inclusion of consumers in the planning process. AIMS This study sought to bring the voice of the consumer with SMI to assist with the integration of primary care and mental health services. METHODS Working with a community advisory board in the City of Philadelphia, we carried out a sequential explanatory mixed-methods study. The team conducted 12 focus groups (n=149) and surveys (n = 137) of consumers with SMI about their experiences of the health care system and perspectives on integrated health. Data from surveys and focus groups were analyzed and integrated. RESULTS Three relevant themes emerged: primary care experiences; health care stigma; and social determinants as barriers to health. Generally, individuals with SMI supported the integration of care, with careful consideration given to social determinants of health, patient privacy, and respect between providers and patients. CONCLUSIONS Integration may reduce health disparities experienced by individuals with SMI, but the process must be informed by intended consumers. Policymakers and administrators will need to address barriers to care, healthcare stigma, and social determinants of health. Nurses are well placed to inform and lead healthcare integration and overcome the siloing of mental and physical healthcare systems.
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Affiliation(s)
- Kathleen Fisher
- Kathleen Fisher, PhD, CRNP, Drexel University, Philadelphia, PA, USA
| | - Guy Weissinger
- Guy Weissinger, PhD, RN, Villanova University, Villanova, PA, USA
| | - Rosemary O'Rorke
- Rosemary O'Rorke, MEd, The Philadelphia Coalition, Philadelphia, PA, USA
| | - Erica Edwards
- Erica Edwards, MSW, The Consortium, Philadelphia, PA, USA
| | - Guy Diamond
- Guy Diamond, PhD, Drexel University, Philadelphia, PA, USA
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74
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Borkent J, Ioannou M, Laman JD, Haarman BCM, Sommer IEC. Role of the gut microbiome in three major psychiatric disorders. Psychol Med 2022; 52:1222-1242. [PMID: 35506416 PMCID: PMC9157303 DOI: 10.1017/s0033291722000897] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 01/14/2022] [Accepted: 03/18/2022] [Indexed: 12/19/2022]
Abstract
Major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia-spectrum disorders (SSD) are heterogeneous psychiatric disorders, which place significant burden on patient's well-being and global health. Disruptions in the gut-microbiome may play a role in these psychiatric disorders. This review presents current data on composition of the human gastrointestinal microbiota, and its interaction mechanisms in the gut-brain axis in MDD, BD and SSD. Diversity metrics and microbial relative abundance differed across studies. More studies reported inconsistent findings (n = 7) or no differences (n = 8) than studies who reported lower α-diversity in these psychiatric disorders (n = 5). The most consistent findings across studies were higher relative abundances of the genera Streptococcus, Lactobacillus, and Eggerthella and lower relative abundance of the butyrate producing Faecalibacterium in patients with psychiatric disorders. All three increased genera were associated with higher symptom severity. Confounders, such as medication use and life style have not been accounted for. So far, the results of probiotics trials have been inconsistent. Most traditional and widely used probiotics (consisting of Bifidobacterium spp. and Lactobacillus spp.) are safe, however, they do not correct potential microbiota disbalances in these disorders. Findings on prebiotics and faecal microbiota transplantation (FMT) are too limited to draw definitive conclusions. Disease-specific pro/prebiotic treatment or even FMT could be auspicious interventions for prevention and therapy for psychiatric disorders and should be investigated in future trials.
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Affiliation(s)
- Jenny Borkent
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Magdalini Ioannou
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jon D. Laman
- Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bartholomeus C. M. Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Iris E. C. Sommer
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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75
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Shin DS, Noh HM, Song HJ, Park KH, Seo YG, Paek YJ. Association between Low-Dose Computed Tomography Results and 1-Year Smoking Cessation in a Residential Smoking Cessation Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5510. [PMID: 35564904 PMCID: PMC9102135 DOI: 10.3390/ijerph19095510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic is a global health threat. Smoking and smoking-related lung diseases are risk factors for severe COVID-19 infection. This study investigated whether low-dose computed tomography (LDCT) scan results affected the success of 1-year smoking cessation. The Gyeonggi Southern Smoking Support Center performed the residential smoking cessation program from January to December 2018. During the program, LDCT was performed on 292 participants; 6 months later, follow-up via telephone or visit was conducted. Among the 179 participants who succeeded in smoking cessation for 6 months, telephone follow-up was conducted to determine whether there was a 12-month continuous smoking cessation. In order to evaluate the association between LDCT results and 12-month continuous abstinence rate (CAR), logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI). The CARs at 6 and 12 months were 61.3% and 31.5%, respectively. Indeterminate or suspicious malignant lung nodules were associated with a higher 12-month CAR (OR, 3.02; 95% CI, 1.15-7.98), whereas psychiatric history was associated with a lower 12-month CAR (OR, 0.06; 95% CI, 0.03-0.15). These results suggest that abnormal lung screening results may encourage smokers to quit smoking.
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Affiliation(s)
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea; (D.-S.S.); (H.J.S.); (K.H.P.); (Y.-G.S.)
| | | | | | | | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea; (D.-S.S.); (H.J.S.); (K.H.P.); (Y.-G.S.)
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76
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Covell NH, Foster F, Lipton N, Kingman E, Tse J, Aquila A, Williams JM. Self- Evaluation Tool to Support Implementation of Treatment for Tobacco Use Disorder in Behavioral Health Programs. Community Ment Health J 2022; 58:812-820. [PMID: 34518927 PMCID: PMC8437659 DOI: 10.1007/s10597-021-00890-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/28/2021] [Indexed: 11/28/2022]
Abstract
Tobacco use in people with behavioral health conditions remain two to three times higher than the general population causing premature death and impacting recovery negatively across several domains. Intermediary organizations can provide practical tools, training, and technical assistance to help programs improve capacity to treat tobacco use. This report describes the construction and application of the Tobacco Integration Self-Evaluation Tool (TiSET) for behavioral health programs, a 20-item scale inspired by the DDCMHT and additional content from the Facility Tobacco Policy and Treatment Practices Self-Evaluation tool that one of the study authors (JW) used previously with addiction treatment programs. Completing the TiSET is an important step for behavioral health programs to evaluate their ability to effectively treat people that use tobacco. An important next step is to use those results to facilitate a quality improvement process. We include large agency example illustrating how the TiSET can be applied in real-world practice.
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Affiliation(s)
- Nancy H Covell
- Columbia University Vagelos College of Physicians and Surgeons, Center for Practice Innovations, New York State Psychiatric Institute, New York, NY, USA.
| | - Forrest Foster
- Center for Practice Innovations, New York State Psychiatric Institute, New York, NY, USA
| | - Noah Lipton
- Center for Practice Innovations, New York State Psychiatric Institute, New York, NY, USA
| | - Emily Kingman
- The Institute for Community Living (ICL), Inc. New York, New York, NY, USA
| | - Jeanie Tse
- The Institute for Community Living (ICL), Inc. New York, New York, NY, USA.,New York University and Fountain House, New York, NY, USA
| | - Annie Aquila
- Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Jill M Williams
- Rutgers University-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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77
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Selva Kumar D, Nahvi S, Rivera-Mindt M, Arnsten J, Minami H. The Impact of Coping With Stressful Events on Negative Affect and Cravings Among Smokers With Mood Disorders. Nicotine Tob Res 2022; 24:881-889. [PMID: 34918163 PMCID: PMC9048876 DOI: 10.1093/ntr/ntab260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/11/2021] [Accepted: 12/14/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Smokers with mental illness report elevated levels of stress and negative affect. Craving is often cited as a key precipitant of smoking. Coping with stress has been associated with reduced cravings among smokers attempting to quit. However, the effect of coping with stress on negative affect and craving among smokers with mental illness is not well understood. This study investigated whether coping with stress predicts lower subsequent craving, mediated by reduced negative affect, among socioeconomically disadvantaged smokers with mood disorders. AIMS AND METHODS This study used ecologically momentary assessment (EMA) data from a randomized controlled trial involving smokers with mood disorders. The final sample included 39 participants. RESULTS Traditional mediation path analyses showed that coping with stress predicts lower craving (p = .02) through its impact on negative affect (p < .001) for the contemporaneous model (ie, when craving was measured at the same report as coping). However, coping with stress did not have a prospective effect on craving (ie, when craving was measured at the next report, up to 12 hours later) (p = .11). CONCLUSIONS The results suggest that coping with stress reduces craving through negative effect, but only for a limited timeframe. The findings could guide future research on the length of time that the effect of coping lasts and research on interventions to increase coping with stress among smokers with mental illness. IMPLICATIONS This is the first study to use EMA to demonstrate that coping with stressful events effectively reduces craving through reducing negative affect among smokers with mood disorders. This finding suggests that individuals heavily burdened with stress and negative affect benefit from coping with stress. We utilized within-subject analyses of EMA data which allowed us to understand these effects within an individual near real time. Our sample is hard to reach and ethnoculturally diverse. Findings could guide intervention research on helping smokers with mental illness cope when experiencing stress.
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Affiliation(s)
| | - Shadi Nahvi
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, USA
| | - Monica Rivera-Mindt
- Fordham University, Department of Psychology, Bronx, NY, USA
- Department of Latin American and Latino Studies Institute, Fordham University, Bronx, NY, USA
| | - Julia Arnsten
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, USA
| | - Haruka Minami
- Fordham University, Department of Psychology, Bronx, NY, USA
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78
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Han B, Volkow ND, Blanco C, Tipperman D, Einstein EB, Compton WM. Trends in Prevalence of Cigarette Smoking Among US Adults With Major Depression or Substance Use Disorders, 2006-2019. JAMA 2022; 327:1566-1576. [PMID: 35471512 PMCID: PMC9044114 DOI: 10.1001/jama.2022.4790] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
IMPORTANCE Tobacco use is highly concentrated in persons with mental illness. OBJECTIVES To assess trends in past-month prevalence of cigarette smoking among adults with vs without past-year depression, substance use disorders (SUDs), or both, using nationally representative data. DESIGN, SETTING, AND PARTICIPANTS Exploratory, serial, cross-sectional study based on data from 558 960 individuals aged 18 years or older who participated in the 2006-2019 US National Surveys on Drug Use and Health. EXPOSURE Past-year major depressive episode (MDE) and SUD using Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria. MAIN OUTCOMES AND MEASURES Past-month self-reported cigarette use, adjusted for sociodemographic characteristics. RESULTS Of the sampled 558 960 adults, 41.4% (unweighted) were aged 18 to 25 years, 29.8% (unweighted) were aged 26 to 49 years, and 53.4% (unweighted) were women. From 2006 to 2019, the past-month self-reported cigarette smoking prevalence declined significantly among adults with MDE from 37.3% to 24.2% for an average annual percent change of -3.2 (95% CI, -3.5 to -2.8; P < .001), adults with SUD from 46.5% to 35.8% for an average annual percent change of -1.7 (95% CI, -2.8 to -0.6; P = .002), and adults with co-occurring MDE and SUD from 50.7% to 37.0% for an annual average annual percent change of -2.1 (95% CI, -3.1 to -1.2; P < .001). The prevalence declined significantly for each examined age, sex, and racial and ethnic subgroup with MDE and with SUD (all P < .05), except for no significant changes in American Indian or Alaska Native adults with MDE (P = .98) or with SUD (P = .46). Differences in prevalence of cigarette smoking between adults with vs without MDE declined significantly for adults overall from 11.5% to 6.6%, for an average annual percent change of -3.4 (95% CI, -4.1 to -2.7; P < .001); significant average annual percent change declines were also seen for men (-5.1 [95% CI, -7.2 to -2.9]; P < .001); for women (-2.7 [95% CI, -3.9 to -1.5]; P < .001); for those aged 18 through 25 years (-5.2 [95% CI, -7.6 to -2.8]; P < .001); for those aged 50 years or older (-4.7 [95% CI, -8.0 to -1.2]; P = .01); for Hispanic individuals (-4.4 [95% CI, -8.0 to -0.5]; P = .03), and for White individuals (-3.6 [95% CI, -4.5 to -2.7]; P < .001). For American Indian or Alaska Native adults, prevalence did not significantly differ between those with vs without MDE during 2006-2012 but was significantly higher for those with MDE during 2013-2019 (difference, 11.3%; 95% CI, 0.9 to 21.7; P = .04). Differences among those with vs without SUD declined for women for an average annual percent change of -1.8 (95% CI, -2.8 to -0.9; P = .001). CONCLUSIONS AND RELEVANCE In this exploratory, serial, cross-sectional study, there were significant reductions in the prevalence of self-reported cigarette smoking among US adults with major depressive episode, substance use disorder, or both, between 2006 and 2019. However, continued efforts are needed to reduce the prevalence further.
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Affiliation(s)
- Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Nora D. Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Douglas Tipperman
- Substance Abuse and Mental Health Services Administration, Rockville, Maryland
| | - Emily B. Einstein
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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79
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Rosenfeld LC, Wang P, Holland J, Ruble M, Parsons T, Huang H. Care Management of Comorbid Medical and Psychiatric Illness: A Conceptual Framework for Improving Equity of Care. Popul Health Manag 2022; 25:148-156. [PMID: 35442788 PMCID: PMC9058884 DOI: 10.1089/pop.2021.0366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Psychiatric and medical comorbidities are common among adults in the United States. Due to the complex interplay between medical and psychiatric illness, comorbidities result in substantial disparities in morbidity, mortality, and health care costs. There is, thus, both an ethical and fiscal imperative to develop care management programs to address the needs of individuals with comorbid conditions. Although there is substantial evidence supporting the use of care management for improving health outcomes for patients with chronic diseases, the majority of interventions described in the literature are condition-specific. Given the prevalence of comorbidities, the authors of this article reviewed the literature and drew on their clinical expertise to guide the development of future multimorbidity care management programs. Their review yielded one study of multimorbidity care management and two studies of multimorbidity collaborative care. The authors supplemented their findings by describing three key pillars of effective care management, as well as specific interventions to offer patients based on their psychiatric diagnoses and illness severity. The authors proposed short-, medium-, and long-term indicators to measure and track the impact of care management programs on disparities in care. Future studies are needed to identify which elements of existing multimorbidity collaborative care models are active ingredients, as well as which of the suggested supplemental interventions offer the greatest value.
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Affiliation(s)
- Lisa C Rosenfeld
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Philip Wang
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Hsiang Huang
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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80
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del Casale A, Paolini M, Gentile G, Borro M, Zocchi C, Fiaschè F, Padovano A, Zoppi T, Modesti MN, De Luca O, Pomes LM, Brugnoli R, Ferracuti S, Girardi P, Pompili M, Simmaco M. Dopamine DRD2 and DRD3 Polymorphisms Involvement in Nicotine Dependence in Patients with Treatment-Resistant Mental Disorders. J Pers Med 2022; 12:jpm12040565. [PMID: 35455685 PMCID: PMC9033085 DOI: 10.3390/jpm12040565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/08/2022] [Accepted: 03/28/2022] [Indexed: 12/04/2022] Open
Abstract
Patients affected by mental disorders smoke more than the general population. The reasons behind this habit are genetic, environmental, etc. This study aims to investigate the correlations between some polymorphisms and the smoking habits and nicotine dependence in patients with psychiatric disorders. We recruited 88 patients with treatment-resistant mental disorders, including 35 with major depressive disorder, 43 with bipolar spectrum disorder, and 10 with schizophrenia spectrum disorder. We carried out a clinical and psychometric assessment on current smoking habits, years of smoking, number of daily cigarettes, and level of nicotine addiction. The patients performed a peripheral blood sample for DNA analyses of different polymorphisms. We searched for correlations between the measures of nicotine addiction and analysed genotypes. The expression of the T allele of the DRD2 rs1800497 and DRD3 rs6280 polymorphisms significantly correlated with a lower level of nicotine dependence and lower use of cigarettes. We did not find significant correlations between nicotine dependence and OPRM1 rs1799971, COMT rs4680 and rs4633 polymorphisms, CYP2A6 rs1801272 and rs28399433, or 5-HTTLPR genotype. Concluding, DRD2 rs1800497 and DRD3 rs6280 polymorphisms are involved in nicotine dependence and cigarette smoking habits in patients with treatment-resistant mental disorders
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Affiliation(s)
- Antonio del Casale
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Via degli Apuli 2, 00185 Rome, Italy;
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
- Correspondence: ; Tel.: +39-0633777774
| | - Marco Paolini
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
| | - Giovanna Gentile
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy
| | - Marina Borro
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy
| | - Clarissa Zocchi
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
| | - Federica Fiaschè
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
| | - Alessio Padovano
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
| | - Teodolinda Zoppi
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
| | - Martina Nicole Modesti
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
| | - Ottavia De Luca
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy
| | - Leda Marina Pomes
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy
| | - Roberto Brugnoli
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
| | - Stefano Ferracuti
- Department of Human Neuroscience, Sapienza University, Viale dell’Università 30, 00185, Rome, Italy;
- Unit of Risk Management, ‘Sant’Andrea’University Hospital, Via di Grottarossa, 00189 Rome, Italy
| | - Paolo Girardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Via degli Apuli 2, 00185 Rome, Italy;
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
| | - Maurizio Pompili
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy; (M.P.); (C.Z.); (F.F.); (A.P.); (T.Z.); (M.N.M.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 00189 Rome, Italy; (G.G.); (M.B.); (O.D.L.); (L.M.P.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, Via di Grottarossa, 00189 Rome, Italy
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81
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Badanapurkar A, Nelson D, Varghese S, Singh R, Haddad PM. Support and attitudes of Qatar mental health professionals to a proposed mental health inpatient smoking ban: Results of a cross-sectional survey. J Psychiatr Ment Health Nurs 2022; 29:327-345. [PMID: 34143910 DOI: 10.1111/jpm.12777] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Smoking is more common among people with serious mental illness, and it contributes to a reduced life expectancy. Several Western countries have successfully introduced smoke-free policies in inpatient mental health units. There is virtually no information about attitudes to smoking bans in mental health units from countries in the Middle East and North Africa region. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We surveyed mental health professionals working in Qatar's main mental health service to determine support for and attitudes towards a proposed total smoking ban in psychiatric wards. Most staff who completed the survey supported an inpatient smoking ban. However, further analysis, both quantitative and qualitative, showed markedly ambivalent attitudes, that is staff simultaneously held attitudes that supported and opposed a smoking ban. Professionals who did not support a ban were more likely to have not received smoking cessation training in the last 5 years, to be a psychiatrist rather than a nurse or allied mental health professional, to be current smokers and to be a Middle Eastern and North African national. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further staff training is necessary to achieve more consistent attitudes that support a total smoking ban and increase the likelihood of successful implementation. The attitudes in this study showed similarities and differences to those reported for mental health professionals in Western countries. This highlights that local research is necessary to help shape training and successfully implement smoke-free policies. ABSTRACT: Introduction Despite the fact that patients with serious mental illness (SMI) have high rates of smoking and an increased standardized mortality, there is virtually no information about attitudes to smoking bans in mental health units from countries in the Middle East and North Africa region. Aim To assess support for, and attitudes towards, a proposed total smoking ban in psychiatric wards among mental health clinicians in Qatar. Method Cross-sectional survey of mental health professionals working in Qatar's primary mental health service. Results The response rate was 68% (353/520). Support for a ban was assessed with a single-item question; 73% of respondents supported a ban with opposition significantly (p < .05) associated with being a current smoker, a Middle Eastern and North African (MENA) national, a psychiatrist versus a mental health nurse or allied health professional and not receiving smoking cessation training in the last 5 years. A 21-item questionnaire assessed attitudes to a total smoking ban. It showed marked ambivalence with multiple linear regression identifying MENA nationality, male gender and current smoking status as independent variables influencing attitudes. The most strongly held attitude supporting a ban was concern about passive smoking and against a ban was concern it may increase patient agitation. Qualitative data confirmed ambivalent views. Discussion The results show similarities and differences to research from other countries suggesting that cultural factors influence some attitudes to smoke-free policies. Implications for Practice Staff support and smoking cessation education are necessary to achieve more consistent staff attitudes to support smoke-free policies.
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Affiliation(s)
| | - Deborah Nelson
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar.,Curtin University, Perth, WA, Australia
| | - Sejo Varghese
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar
| | - Rajvir Singh
- Acute Care Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Peter M Haddad
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar.,College of Medicine, Qatar University, Doha, Qatar.,University of Manchester, Manchester, UK
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82
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Lambert AM, Parretti HM, Pearce E, Price MJ, Riley M, Ryan R, Tyldesley-Marshall N, Avşar TS, Matthewman G, Lee A, Ahmed K, Odland ML, Correll CU, Solmi M, Marshall T. Temporal trends in associations between severe mental illness and risk of cardiovascular disease: A systematic review and meta-analysis. PLoS Med 2022; 19:e1003960. [PMID: 35439243 PMCID: PMC9017899 DOI: 10.1371/journal.pmed.1003960] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/08/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Severe mental illness (SMI; schizophrenia, bipolar disorders (BDs), and other nonorganic psychoses) is associated with increased risk of cardiovascular disease (CVD) and CVD-related mortality. To date, no systematic review has investigated changes in population level CVD-related mortality over calendar time. It is unclear if this relationship has changed over time in higher-income countries with changing treatments. METHODS AND FINDINGS To address this gap, a systematic review was conducted, to assess the association between SMI and CVD including temporal change. Seven databases were searched (last: November 30, 2021) for cohort or case-control studies lasting ≥1 year, comparing frequency of CVD mortality or incidence in high-income countries between people with versus without SMI. No language restrictions were applied. Random effects meta-analyses were conducted to compute pooled hazard ratios (HRs) and rate ratios, pooled standardised mortality ratios (SMRs), pooled odds ratios (ORs), and pooled risk ratios (RRs) of CVD in those with versus without SMI. Temporal trends were explored by decade. Subgroup analyses by age, sex, setting, world region, and study quality (Newcastle-Ottawa scale (NOS) score) were conducted. The narrative synthesis included 108 studies, and the quantitative synthesis 59 mortality studies (with (≥1,841,356 cases and 29,321,409 controls) and 28 incidence studies (≥401,909 cases and 14,372,146 controls). The risk of CVD-related mortality for people with SMI was higher than controls across most comparisons, except for total CVD-related mortality for BD and cerebrovascular accident (CVA) for mixed SMI. Estimated risks were larger for schizophrenia than BD. Pooled results ranged from SMR = 1.55 (95% confidence interval (CI): 1.33 to 1.81, p < 0.001), for CVA in people with BD to HR/rate ratio = 2.40 (95% CI: 2.25 to 2.55, p < 0.001) for CVA in schizophrenia. For schizophrenia and BD, SMRs and pooled HRs/rate ratios for CHD and CVD mortality were larger in studies with outcomes occurring during the 1990s and 2000s than earlier decades (1980s: SMR = 1.14, 95% CI: 0.57 to 2.30, p = 0.71; 2000s: SMR = 2.59, 95% CI: 1.93 to 3.47, p < 0.001 for schizophrenia and CHD) and in studies including people with younger age. The incidence of CVA, CVD events, and heart failure in SMI was higher than controls. Estimated risks for schizophrenia ranged from HR/rate ratio 1.25 (95% CI: 1.04 to 1.51, p = 0.016) for total CVD events to rate ratio 3.82 (95% CI: 3.1 to 4.71, p < 0.001) for heart failure. Incidence of CHD was higher in BD versus controls. However, for schizophrenia, CHD was elevated in higher-quality studies only. The HR/rate ratios for CVA and CHD were larger in studies with outcomes occurring after the 1990s. Study limitations include the high risk of bias of some studies as they drew a comparison cohort from general population rates and the fact that it was difficult to exclude studies that had overlapping populations, although attempts were made to minimise this. CONCLUSIONS In this study, we found that SMI was associated with an approximate doubling in the rate ratio of CVD-related mortality, particularly since the 1990s, and in younger groups. SMI was also associated with increased incidence of CVA and CHD relative to control participants since the 1990s. More research is needed to clarify the association between SMI and CHD and ways to mitigate this risk.
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Affiliation(s)
- Amanda M Lambert
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Helen M Parretti
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Emma Pearce
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Malcolm J Price
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.,NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, United Kingdom
| | - Mark Riley
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Ronan Ryan
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | | | - Tuba Saygın Avşar
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Gemma Matthewman
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Alexandra Lee
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Khaled Ahmed
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Maria Lisa Odland
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.,Department of Obstetrics and Gynecology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Malawi-Liverpool-Wellcome Trust Research Institute, Blantyre, Malawi.,Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom
| | - Christoph U Correll
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, New York, United States of America.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York, United States of America.,Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada.,Department of Mental Health, The Ottawa Hospital, Ontario, Canada.,Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario, Canada
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
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83
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Lin SC, Gathua N, Thompson C, Sripipatana A, Makaroff L. Disparities in smoking prevalence and associations with mental health and substance use disorders in underserved communities across the United States. Cancer 2022; 128:1826-1831. [PMID: 35253202 DOI: 10.1002/cncr.34132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Smoking contributes to the top 3 deadliest cancers, cancers of the lung, colon, and pancreas, which account for nearly 40% of all cancer-related deaths in the United States. Despite historicly low smoking rates, substantial disparities remain among people with mental health conditions and substance use disorders (SUDs). METHODS The study examined the prevalence of smoking among adults from underserved communities who are served at federally qualified health centers through an analysis of the 2014 Health Center Patient Survey. Furthermore, the study assessed associations of smoking with co-occurring mental health conditions and SUDs among adult smokers (n = 1735). RESULTS The prevalence of smoking among health center patients was 28.1%. Among current smokers, 59.1% had depression and 45.4% had generalized anxiety. Non-Hispanic Black smokers had more than 2 times the odds of reporting SUDs (adjusted odds ratio [aOR], 2.13; 95% confidence interval [CI], 1.06-4.30). Individuals at or below 100% of the federal poverty level had more than 2 times the odds of having mental health conditions (aOR, 2.55; 95% CI, 1.58-4.11), and those who were unemployed had more than 3 times the odds for SUDs (aOR, 3.21; 95% CI, 1.27-8.10). CONCLUSIONS The prevalence of smoking in underserved communities is nearly double the national prevalence. In addition, the study underscores important socioeconomic determinants of health in smoking cessation behavior and the marked disparities among individuals with mental health conditions and SUDs. Finally, the findings illuminate the unique need for tailored treatments supporting cancer prevention care to address challenges confronted by vulnerable populations.
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Affiliation(s)
- Sue C Lin
- Office of Quality Improvement, Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland
| | - Naomie Gathua
- Office of Quality Improvement, Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland
| | - Cheryl Thompson
- Office of Quality Improvement, Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland
| | - Alek Sripipatana
- Office of Quality Improvement, Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland
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84
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Perman-Howe PR, Horton M, Robson D, McDermott MS, McNeill A, Brose LS. Harm perceptions of nicotine-containing products and associated sources of information in UK adults with and without mental ill health: A cross-sectional survey. Addiction 2022; 117:715-729. [PMID: 34338387 DOI: 10.1111/add.15657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS People with mental ill health are more likely to smoke and experience smoking-related harm than those without. Switching from combustible tobacco to lower-risk nicotine-containing products may be of benefit; however, misperceptions of harm may prevent their use. We aimed to assess, among adults with and without mental ill health, (1) perceptions of harm from nicotine and relative harm and addictiveness of different nicotine-containing products and (2) sources of information associated with harm perceptions. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS On-line survey of adults (n = 3400) who smoke cigarettes and/or use e-cigarettes, or have recently stopped, in the United Kingdom. MEASUREMENTS Outcomes: harm perceptions of nicotine; relative perceived harm and addictiveness of different nicotine-containing products; sources of information for harm perceptions of nicotine, cigarette smoking and e-cigarettes. Demographics: sex, age, education, ethnic group and region. Other measures: self-reported smoking, vaping and mental health status. ANALYSES frequencies and logistic regressions adjusting for demographic/other measures. FINDINGS Among those with serious mental distress (versus no/low mental distress): 9.6% [13.9%, adjusted odds ratio (aOR) = 0.69, 95% confidence interval (CI) = 0.50-0.97] correctly identified that none/a very small amount of the health risks of smoking cigarettes come from nicotine; 41.7% (53.5%, aOR = 0.67, 95% CI = 0.54-0.84) perceived e-cigarettes and 53.2% (70.3%, aOR = 0.62, 95% CI = 0.50-0.77) perceived nicotine replacement therapy to be less harmful than cigarettes; and 42.1% (51.3%, aOR = 0.77, 95% CI = 0.62-0.95) perceived e-cigarettes as being less likely than cigarettes to cause cancer, 35.4% (45.5%, aOR = 0.71, 95% CI = 0.57-0.88) heart attacks and 34.9% (42.3%, aOR = 0.80, 95% CI = 0.64-0.99) lung problems. The most popular sources of information for cigarette smoking, e-cigarettes and nicotine were scientific experts' opinions and media reports, with little variation by mental distress. CONCLUSIONS Among adults with a history of tobacco and/or e-cigarette use, those with serious mental distress appear to have less accurate harm perceptions of nicotine and nicotine-containing products than those with no/low distress, despite reporting similar sources of information.
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Affiliation(s)
- Parvati R Perman-Howe
- King's College London, Addiction Sciences Building, London, UK
- SPECTRUM Consortium, UK
| | - Marie Horton
- Public Health UK, South Bank, London, UK
- SPECTRUM Consortium, UK
| | - Deborah Robson
- King's College London, Addiction Sciences Building, London, UK
- SPECTRUM Consortium, UK
| | | | - Ann McNeill
- King's College London, Addiction Sciences Building, London, UK
- SPECTRUM Consortium, UK
| | - Leonie S Brose
- King's College London, Addiction Sciences Building, London, UK
- SPECTRUM Consortium, UK
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85
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Yuan CT, McGinty EE, Dalcin A, Goldsholl S, Dickerson F, Gudzune KA, Jerome GJ, Thompson DA, Murphy KA, Minahan E, Daumit GL. Scaling Evidence-Based Interventions to Improve the Cardiovascular Health of People With Serious Mental Illness. Front Psychiatry 2022; 13:793146. [PMID: 35185650 PMCID: PMC8855048 DOI: 10.3389/fpsyt.2022.793146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
People with serious mental illnesses (SMIs) experience excess mortality, driven in large part by high rates of cardiovascular disease (CVD), with all cardiovascular disease risk factors elevated. Interventions designed to improve the cardiovascular health of people with SMI have been shown to lead to clinically significant improvements in clinical trials; however, the uptake of these interventions into real-life clinical settings remains limited. Implementation strategies, which constitute the "how to" component of changing healthcare practice, are critical to supporting the scale-up of evidence-based interventions that can improve the cardiovascular health of people with SMI. And yet, implementation strategies are often poorly described and rarely justified theoretically in the literature, limiting the ability of researchers and practitioners to tease apart why, what, how, and when implementation strategies lead to improvement. In this Perspective, we describe the implementation strategies that the Johns Hopkins ALACRITY Center for Health and Longevity in Mental Illness is using to scale-up three evidenced-based interventions related to: (1) weight loss; (2) tobacco smoking cessation treatment; and (3) hypertension, dyslipidemia, and diabetes care for people with SMI. Building on concepts from the literature on complex health interventions, we focus on considerations related to the core function of an intervention (i.e., or basic purposes of the change process that the health intervention seeks to facilitate) vs. the form (i.e., implementation strategies or specific activities taken to carry out core functions that are customized to local contexts). By clearly delineating how implementation strategies are operationalized to support the interventions' core functions across these three studies, we aim to build and improve the future evidence base of how to adapt, implement, and evaluate interventions to improve the cardiovascular health of people with SMI.
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Affiliation(s)
- Christina T. Yuan
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Emma E. McGinty
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Arlene Dalcin
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Stacy Goldsholl
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | | | - Kimberly A. Gudzune
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Gerald J. Jerome
- Department of Kinesiology, Towson University, Towson, MD, United States
| | - David A. Thompson
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Karly A. Murphy
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Eva Minahan
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Gail L. Daumit
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
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86
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Fan Z, Gong X, Xu H, Wang H, Zeng N, Li L, Yan C, Wu L, Chen Y. Gender differences in the associations between tobacco smoke exposure and depressive symptoms among U.S. adults: NHANES 2007-2018. J Psychiatr Res 2022; 146:249-257. [PMID: 34799126 DOI: 10.1016/j.jpsychires.2021.11.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Findings concerning gender differences in the associations between tobacco smoke exposure (TSE) and depression are inconsistent. This study aimed to investigate the gender-specific associations between active and passive TSE with depressive symptoms in a large, nationally representative sample of U.S. adults. METHODS Data were from 27,175 adults aged ≥20 years in the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Multivariable logistic regression was used to adjust for possible confounders. Whether the TSE-depression relationships may differ by age, race/ethnicity, socioeconomic status, body mass index (BMI), and self-reported health status was examined. RESULTS After adjustment for lifestyle- and health-related variables, no significant associations between active (OR, 1.16 [95% CI, 0.87-1.55]) and passive TSE (OR, 0.84 [95% CI, 0.59-1.19]) and depressive symptoms were found among men. Among women, active TSE was associated with depressive symptoms (OR, 1.90 [95% CI, 1.51-2.39]), while the association for passive TSE was nonsignificant (OR, 1.11 [95% CI, 0.91-1.34]) after adjusting for lifestyle- and health-related variables. Interaction and subgroup analyses showed that self-reported health status could modify the relationship between passive TSE and depressive symptoms among women. Furthermore, a dose-response relationship between serum cotinine and depressive symptoms was found in women, but not in men. CONCLUSIONS This study suggests a stronger TSE-depression association in women than in men. Understanding these gender-specific patterns and identifying the potential moderators of such relationships will enable better targeting of public health interventions.
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Affiliation(s)
- Zhixin Fan
- Research Center for Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Xiayu Gong
- Research Center for Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Hanfang Xu
- Research Center for Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Hanzhang Wang
- Research Center for Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Ningxi Zeng
- Research Center for Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Ling Li
- Research Center for Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Can Yan
- Research Center for Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Lili Wu
- Research Center for Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.
| | - Yuan Chen
- Animal Laboratory Center, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.
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87
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Lawrence D, Johnson SE, Mitrou F, Lawn S, Sawyer M. Tobacco smoking and mental disorders in Australian adolescents. Aust N Z J Psychiatry 2022; 56:164-177. [PMID: 33908298 DOI: 10.1177/00048674211009617] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aimed to (1) examine the strength of the association between mental disorders/mental health problems, risk behaviours and tobacco smoking among Australian adolescents, (2) compare rates of tobacco smoking among Australian adolescents with major depressive disorder, attention-deficit/hyperactivity disorder and/or conduct disorder in 2013/14 vs 1998, and (3) identify the extent to which an association between tobacco smoking and mental health problems among adolescents can be attributed to non-mental health risk factors. METHODS The study utilised data from the first (1998) and second (2013/14) child and adolescent components of the National Surveys of Mental Health and Wellbeing. Both surveys identified nationally representative samples of Australian young people aged 4-17 years, living in private dwellings. Information was collected from parents and 13- to 17-year-olds about mental disorders, mental health problems, risk behaviours and tobacco smoking. RESULTS In the 2013/14 survey, the rate of current tobacco smoking among those with a mental disorder was 20% compared to 5% in those without a mental disorder. Rates were highest for young people with conduct disorder (50%), major depressive disorder (24%) and anxiety disorders (19%). In 2013/14, 38% of current tobacco smokers had a mental disorder and 32% reported self-harm and/or suicidal ideation vs 10% and 5%, respectively, among adolescents who had never smoked. Females with mental disorders or reporting self-harm or suicidal ideation had higher rates of current smoking than males. Other significant factors associated with current smoking included school-related problems, binge eating and having had more than one sexual partner. CONCLUSION While smoking rates in 13- to 17-year-olds with mental disorders had declined since 1998, the strength of the association between mental disorders and smoking had increased, especially among females. Our findings highlight the need to address the tobacco smoking among adolescents with mental disorders, particularly females.
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Affiliation(s)
- David Lawrence
- Graduate School of Education, The University of Western Australia, Perth, WA, Australia
| | - Sarah E Johnson
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Francis Mitrou
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Sharon Lawn
- Flinders Human Behaviour and Health Research Unit, College of Medicine & Public Health, Margaret Tobin Centre, Adelaide, SA, Australia
| | - Michael Sawyer
- School of Psychology and Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
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88
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Hanly G, Campbell E, Bartlem K, Dray J, Fehily C, Bradley T, Murray S, Lecathelinais C, Wiggers J, Wolfenden L, Reid K, Reynolds T, Bowman J. Effectiveness of referral to a population-level telephone coaching service for improving health risk behaviours in people with a mental health condition: study protocol for a randomised controlled trial. Trials 2022; 23:49. [PMID: 35039058 PMCID: PMC8762844 DOI: 10.1186/s13063-021-05971-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with a mental health condition have a shorter life expectancy than the general population. This is largely attributable to higher rates of chronic disease and a higher prevalence of modifiable health risk behaviours including tobacco smoking, alcohol consumption, poor nutrition, and physical inactivity. Telephone support services offer a viable option to provide support to reduce these health risk behaviours at a population-level; however, whilst there is some research pertaining to Quitlines, there is limited other research investigating whether telephone services may offer effective support for people with a mental health condition. This protocol describes a randomised controlled trial that aims to evaluate the referral of people with a mental health condition to a population-level telephone coaching service to increase physical activity, healthy eating, or weight management, and increase attempts to do so. METHODS A parallel-group randomised controlled trial will be conducted recruiting participants with a mental health condition through community mental health services and advertisement on social media. Participants will be randomly assigned to receive either a health information pack only (control) or a health information pack and a proactive referral to a free, government-funded telephone coaching service, the NSW Get Healthy Coaching and Information Service® (intervention), which offers up to 13 telephone coaching calls with a University Qualified Health Coach to assist with client-identified goals relating to physical activity, healthy eating, weight management, or alcohol reduction. Data will be collected via telephone surveys at baseline and 6 months post-recruitment. Primary outcomes are as follows: (1) minutes of moderate to vigorous physical activity per week, (2) serves of fruit consumed per day, (3) serves of vegetables consumed per day, and (4) a composite measure assessing attempts to change at least one health risk behaviour (any attempts to change physical activity, fruit consumption, vegetable consumption, or other parts of nutrition). Secondary outcomes include weight and body mass index. DISCUSSION This study is the first to evaluate the effectiveness of referral to a population-level telephone support service for reducing health risk behaviours relating to physical activity, healthy eating, and weight in people with a mental health condition. Results will inform future policy and practice regarding the delivery of telephone-based behaviour change coaching services and the management of physical health for this population to reduce health inequity and the burden of chronic disease. TRIAL REGISTRATION The Australian New Zealand Clinical Trials Registry ACTRN12620000351910 . Retrospectively registered on 12 March 2020.
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Affiliation(s)
- Grace Hanly
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Elizabeth Campbell
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
| | - Kate Bartlem
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Julia Dray
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Caitlin Fehily
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Tegan Bradley
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Sonya Murray
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
| | - Christophe Lecathelinais
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - John Wiggers
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
| | - Luke Wolfenden
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
| | - Kate Reid
- NSW Office of Preventive Health, Liverpool, NSW Australia
| | | | - Jenny Bowman
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
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89
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Huddlestone L, Shoesmith E, Pervin J, Lorencatto F, Watson J, Ratschen E. A systematic review of mental health professionals, patients and carers' perceived barriers and enablers to supporting smoking cessation in mental health settings. Nicotine Tob Res 2022; 24:945-954. [PMID: 35018458 PMCID: PMC9199941 DOI: 10.1093/ntr/ntac004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/20/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022]
Abstract
Introduction Evidence-based smoking cessation and temporary abstinence interventions to address smoking in mental health settings are available, but the impact of these interventions is limited. Aims and Methods We aimed to identify and synthesize the perceived barriers and enablers to supporting smoking cessation in mental health settings. Six databases were searched for articles reporting the investigation of perceived barriers and enablers to supporting smoking cessation in mental health settings. Data were extracted and coded using a mixed inductive/deductive method to the theoretical domains framework, key barriers and enablers were identified through the combining of coding frequency, elaboration, and expressed importance. Results Of 31 included articles, 56 barriers/enablers were reported from the perspectives of mental healthcare professionals (MHPs), 48 from patient perspectives, 21 from mixed perspectives, and 0 from relatives/carers. Barriers to supporting smoking cessation or temporary abstinence in mental health settings mainly fell within the domains: environmental context and resources (eg, MHPs lack of time); knowledge (eg, interactions around smoking that did occur were ill informed); social influences (eg, smoking norms within social network); and intentions (eg, MHPs lack positive intentions to deliver support). Enablers mainly fell within the domains: environmental context and resources (eg, use of appropriate support materials) and social influences (eg, pro-quitting social norms). Conclusions The importance of overcoming competing demands on staff time and resources, the inclusion of tailored, personalized support, the exploitation of patients wider social support networks, and enhancing knowledge and awareness around the benefits smoking cessation is highlighted. Implications Identified barriers and enablers represent targets for future interventions to improve the support of smoking cessation in mental health settings. Future research needs to examine the perceptions of the carers and family/friends of patients in relation to the smoking behavior change support delivered to patients.
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Affiliation(s)
| | | | - Jodi Pervin
- Department of Health Sciences, University of York, York
| | | | - Jude Watson
- Department of Health Sciences, University of York, York
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90
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Zolezzi M, Al-Rawi S, Eltorki Y. An Exploration of Smoking Patterns Among People with Serious Mental Illness Attending an Outpatient Clinic in Qatar. Neuropsychiatr Dis Treat 2022; 18:2847-2854. [PMID: 36518535 PMCID: PMC9743978 DOI: 10.2147/ndt.s385970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Studies have shown that tobacco use is exceptionally high in people affected with serious mental illness (SMI). Many countries worldwide have observed a decrease in the prevalence of tobacco smoking; however, the smoking rates among people with SMI have declined much less than in those without mental illness. To date, no nationally representative data have examined the smoking patterns or the sociocultural factors that influence smoking among SMI people in Qatar. METHODS A retrospective medical chart review was conducted to collect patient demographics, psychiatric and medical comorbidities, medications, the most recently documented smoking status and if on tobacco cessation treatment. A descriptive and inferential analysis of the data was performed. RESULTS Of 346 patients included in the cohort, 196 (56.6%) had their smoking status documented, of which 72 (36.7%) were "currently smoking." Significantly more males than females were "current smokers" (62.9% versus 15.0%, respectively, p < 0.001). Significantly more patients with psychotic disorders than those with any other SMI were "current smokers", and this difference was statistically significant (p = 0.006). Positive and significant associations with current smoking were found for the male gender, psychotic disorders, and high levels (≥6.2 mmol/L) of total cholesterol. Only 12 (16.7%) of current smokers were receiving smoking cessation treatment. CONCLUSION More than half of a sample of people with SMI attending outpatient psychiatric services in Qatar had documented smoking status. Still, only a few current smokers were on smoking cessation treatment. Efforts are needed to implement smoking cessation strategies in this population.
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Affiliation(s)
- Monica Zolezzi
- Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Safa Al-Rawi
- Al Wakrah Hospital, Hamad Medical Corporation (HMC), Doha, Qatar
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91
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Turner E, Berry K, Aggarwal VR, Quinlivan L, Villanueva T, Palmier-Claus J. Oral health self-care behaviours in serious mental illness: A systematic review and meta-analysis. Acta Psychiatr Scand 2022; 145:29-41. [PMID: 33862664 DOI: 10.1111/acps.13308] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
Abstract
AIM To understand the relationship between serious mental illness and oral health self-care behaviours using meta-analytic methods and a narrative synthesis of available literature. METHOD The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines [PROSPERO reference: CRD42020176779]. Search terms pertaining to serious mental illness and oral health were entered into EMBASE, PsycINFO, Medline and CINAHL. Eligible studies included a sample of people with a serious mental illness and a quantitative measure of an oral health self-care behaviour (eg dental visits, toothbrushing). The Effective Public Health Practice Project tool was utilised to appraise the quality of the literature. Studies in the meta-analysis contained a non-clinical or general population comparator sample. RESULTS People with a serious mental illness were significantly less likely to visit the dentist (OR 0.46, 95% CI 0.32-0.065, p > 0.001) or brush their teeth (OR 0.19, 95% CI 0.08-0.42, p < 0.001) when compared to non-clinical comparator samples. Few studies explored other oral health self-care behaviours (eg flossing and mouth washing), but uptake was generally low in people with a serious mental illness. The study quality of included studies was variable. CONCLUSIONS The research showed a reduced uptake of oral health self-care behaviours in people with a serious mental illness. Suboptimal oral health can negatively impact on physical, social and psychological functioning. Further research is needed to understand the reasons for low rates of oral health self-care behaviours in this population.
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Affiliation(s)
- Elizabeth Turner
- Division of Psychology & Mental Health, The University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Katherine Berry
- Division of Psychology & Mental Health, The University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Vishal R Aggarwal
- School of Dentistry, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
| | - Leah Quinlivan
- Division of Psychology & Mental Health, The University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Jasper Palmier-Claus
- The Spectrum Centre for Mental Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK.,Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
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92
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Lee H, Singh GK. Contributions of Socioeconomic, Demographic, and Behavioral Risk Factors to All-Cause Mortality Disparities by Psychological Distress in the United States: A Blinder-Oaxaca Decomposition Analysis of Longitudinal Data. Int J MCH AIDS 2022; 11:e533. [PMID: 35601679 PMCID: PMC9005888 DOI: 10.21106/ijma.533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Previous research has shown a significant association between psychological distress (PD) and all-cause mortality. However, there is a dearth of studies quantifying the contributions of sociodemographic and behavioral characteristics to group differences in mortality. In this study, we identify factors of mortality differences by PD. METHODS The Blinder-Oaxaca decomposition analysis was used to quantify the contributions of individual sociodemographic and behavioral characteristics to the observed mortality differences between United States (US) adults with no PD and those with serious psychological distress (SPD), using the pooled data from the 1997-2014 National Health Interview Survey prospectively linked to the 1997-2015 National Death Index (N = 263,825). RESULTS Low educational level, low household income, and high proportions of current smokers, renters, former drinkers, and adults experiencing marital dissolution contributed to high all-cause mortality among adults with SPD. The relative percentage of all-cause mortality disparity explained by socioeconomic and demographic factors was 38.86%. Approximately 47% of the mortality disparity was attributed to both sociodemographic and behavioral risk factors. Lower educational level (21.13%) was the top contributor to higher all-cause mortality among adults with SPD, followed by smoking status (13.51%), poverty status (11.77%), housing tenure (5.11%), alcohol consumption (4.82%), marital status (3.61%), and nativity/immigrant status (1.95%). Age, sex, and body mass index alleviated all-cause mortality risk among adults with SPD. CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS Improved education and higher income levels, and reduced smoking among US adults with SPD might eliminate around half of the all-cause mortality disparity by SPD. Such a policy strategy might lead to reductions in mental health disparities and adverse health impacts both in the US and globally.
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Affiliation(s)
- Hyunjung Lee
- Department of Public Policy and Public Affairs, John McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, 100 William T Morrissey Blvd. Boston, MA 02125, United States
| | - Gopal K Singh
- The Center for Global Health and Health Policy, Global Health and Education Projects, Inc., Riverdale, MD 20738, United States
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93
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Baker AL, McCarter K, Brophy L, Castle D, Kelly PJ, Cocks N, McKinlay ML, Brasier C, Borland R, Bonevski B, Segan C, Baird DE, Turner A, Williams JM, Forbes E, Hayes L, Attia J, Lambkin D, Barker D, Sweeney R. Adapting Peer Researcher Facilitated Strategies to Recruit People Receiving Mental Health Services to a Tobacco Treatment Trial. Front Psychiatry 2022; 13:869169. [PMID: 35722563 PMCID: PMC9199858 DOI: 10.3389/fpsyt.2022.869169] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/26/2022] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION One of the most challenging aspects of conducting intervention trials among people who experience severe mental illness (SMI) and who smoke tobacco, is recruitment. In our parent "QuitLink" randomized controlled trial (RCT), slower than expected peer researcher facilitated recruitment, along with the impact of COVID-19 pandemic restrictions, necessitated an adaptive recruitment response. The objectives of the present study were to: (i) describe adaptive peer researcher facilitated recruitment strategies; (ii) explore the effectiveness of these strategies; (iii) investigate whether recruitment strategies reached different subgroups of participants; and (iv) examine the costs and resources required for implementing these strategies. Finally, we offer experience-based lessons in a Peer Researcher Commentary. METHODS People were included in the RCT if they smoked at least 10 cigarettes a day and were accessing mental health support from the project's two partnering mental health organizations in Victoria, Australia. The majority of people accessing these services will have been diagnosed with SMI. Recruitment occurred over 2 years. We began with peer facilitated recruitment strategies delivered face-to-face, then replaced this with direct mail postcards followed by telephone contact. In the final 4 months of the study, we began online recruitment, broadening it to people who smoked and were accessing support or treatment (including from general practitioners) for mental health and/or alcohol or other drug problems, anywhere in the state of Victoria. Differences between recruitment strategies on key participant variables were assessed. We calculated the average cost per enrolee of the different recruitment approaches. RESULTS Only 109 people were recruited from a target of 382: 29 via face-to-face (March 2019 to April 2020), 66 from postcards (May 2020 to November 2020), and 14 from online (November to December 2020 and January to March 2021) strategies. Reflecting our initial focus on recruiting from supported independent living accommodation facilities, participants recruited face-to-face were significantly more likely to be living in partially or fully supported independent living (n = 29, <0.001), but the samples were otherwise similar. After the initial investment in training and equipping peer researchers, the average cost of recruitment was AU$1,182 per participant-~US$850. Face-to-face recruitment was the most expensive approach and postcard recruitment the least (AU$1,648 and AU$928 per participant). DISCUSSION Peer researcher facilitated recruitment into a tobacco treatment trial was difficult and expensive. Widely dispersed services and COVID-19 restrictions necessitated non-face-to-face recruitment strategies, such as direct mail postcards, which improved recruitment and may be worthy of further research. CLINICAL TRIAL REGISTRATION The trial is registered with ANZCTR (www.anzctr.org.au): ACTRN12619000244101 prior to the accrual of the first participant and updated regularly as per registry guidelines. The trial sponsor was the University of Newcastle, NSW, Australia.
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Affiliation(s)
- Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Kristen McCarter
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, NSW, Australia
| | - Lisa Brophy
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Melbourne, VIC, Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and the School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Nadine Cocks
- Research, Advocacy and Policy Development, Mind Australia Limited, Heidelberg, VIC, Australia
| | - Melissa L McKinlay
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Catherine Brasier
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Melbourne, VIC, Australia
| | - Ron Borland
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Cancer Council Victoria, Melbourne, VIC, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute (FHMRI), College of Medicine & Public Health, Flinders University, Bedford Park, SA, Australia
| | - Catherine Segan
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Donita E Baird
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Alyna Turner
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,School of Medicine, IMPACT, Institute for Innovation in Physical and Mental Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Jill M Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Laura Hayes
- Research, Advocacy and Policy Development, Mind Australia Limited, Heidelberg, VIC, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - David Lambkin
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Daniel Barker
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
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94
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Kastaun S, Brose LS, Scholz E, Viechtbauer W, Kotz D. Mental Health Symptoms and Associations with Tobacco Smoking, Dependence, Motivation, and Attempts to Quit: Findings from a Population Survey in Germany (DEBRA Study). Eur Addict Res 2022; 28:287-296. [PMID: 35358964 DOI: 10.1159/000523973] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/04/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aimed to estimate prevalence rates of mental health symptoms (anxiety, depression, and overall psychological distress) by tobacco smoking status, and associations between such symptoms and the level of dependence, motivation, and attempts to quit smoking in the German population. METHODS Cross-sectional analysis of data from six waves of a nationally representative household survey collected in 2018/19 (N = 11,937 respondents aged ≥18). Mental health symptoms were assessed with the Patient Health Questionnaire-4. Associations with smoking status, dependence, motivation to quit, and ≥1 past-year quit attempt (yes/no) were analysed with adjusted regression models among the total group, and among subgroups of current (n = 3,248) and past-year smokers (quit ≤12 months ago, n = 3,357). RESULTS Weighted prevalence rates of mental health symptoms among current, former, and never smokers were: 4.1%, 2.4%, 2.5% (anxiety), 5.4%, 4.7%, 4.0% (depression), and 3.1%, 2.5%, 2.4% (psychological distress). Current versus never smokers were more likely to report symptoms of anxiety and depression. Smokers with higher versus lower levels of dependence were more likely to report higher levels of all three mental health symptoms. Higher versus lower levels of overall psychological distress were associated with a higher motivation to quit smoking and, among past-year smokers, with higher odds of reporting a past-year quit attempt. CONCLUSIONS We found various relevant associations between mental health symptoms and smoking behaviour. Healthcare professionals need to be informed about these associations and trained to effectively support this vulnerable group in translating their motivation into abstinence.
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Affiliation(s)
- Sabrina Kastaun
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Leonie S Brose
- Institute of Psychiatry, Psychology and Neuroscience, Addictions, King's College London, and SPECTRUM consortium, London, United Kingdom
| | - Esther Scholz
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Daniel Kotz
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Department of Behavioural Science and Health, University College London, London, United Kingdom
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95
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Taing M, Nitturi V, Chen TA, Kyburz B, Martinez Leal I, Correa-Fernández V, Obasi EM, Williams T, Casey K, O’Connor DP, Koshy L, Britton M, Drenner K, Reitzel LR. Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:239. [PMID: 35010499 PMCID: PMC8744608 DOI: 10.3390/ijerph19010239] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/03/2021] [Accepted: 12/24/2021] [Indexed: 05/25/2023]
Abstract
Tobacco use is exceedingly high among individuals receiving care for opioid addiction, but not commonly addressed by clinicians in treatment settings. Taking Texas Tobacco Free (TTTF) is a comprehensive tobacco-free workplace (TFW) program that builds treatment centers' capacity to address tobacco use with evidence-based tobacco cessation policies and practices. Here, we examine the process and outcomes of TTTF's implementation within 7 opioid addiction centers. Program goals were structured according to the RE-AIM framework. Pre- and post-implementation data were collected from client facing and non-client facing employees to assess changes in education, training receipt, knowledge, and intervention behaviors, relative to program goals. Centers reported tobacco screenings conducted and nicotine replacement therapy (NRT) delivered through 6 months post-implementation. Overall, 64.56% of employees participated in TTTF-delivered tobacco education, with a 54.9% gain in tobacco control and treatment knowledge (p < 0.0001), and significant increases in exposure to education about tobacco use and harms among individuals with opioid use disorder (p = 0.0401). There were significant gains in clinicians' receipt of training in 9/9 tobacco education areas (ps ≤ 0.0118). From pre- to post-implementation, there were mean increases in the use of the 5A's (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with statistically significant gains seen in NRT provision/referral (p < 0.0001). Several program goals were achieved or exceeded; however, 100% center participation in specialized clinical trainings was among notable exceptions. One program withdrew due to competing pandemic concerns; all others implemented comprehensive TFW policies. Overall, TTTF may have improved participating opioid treatment centers' capacity to address tobacco use, although study limitations, including lower post-implementation evaluation response rates, suggest that results require replication in other opioid addiction treatment settings.
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Affiliation(s)
- Matthew Taing
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA; (M.T.); (V.N.); (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (M.B.); (K.D.)
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
| | - Vijay Nitturi
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA; (M.T.); (V.N.); (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (M.B.); (K.D.)
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
| | - Tzuan A. Chen
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA; (M.T.); (V.N.); (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (M.B.); (K.D.)
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
| | - Bryce Kyburz
- Integral Care, 1430 Collier Street, Austin, TX 78704, USA; (B.K.); (T.W.); (K.C.)
| | - Isabel Martinez Leal
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA; (M.T.); (V.N.); (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (M.B.); (K.D.)
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
| | - Virmarie Correa-Fernández
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA; (M.T.); (V.N.); (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (M.B.); (K.D.)
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
| | - Ezemenari M. Obasi
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA; (M.T.); (V.N.); (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (M.B.); (K.D.)
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
| | - Teresa Williams
- Integral Care, 1430 Collier Street, Austin, TX 78704, USA; (B.K.); (T.W.); (K.C.)
| | - Kathleen Casey
- Integral Care, 1430 Collier Street, Austin, TX 78704, USA; (B.K.); (T.W.); (K.C.)
| | - Daniel P. O’Connor
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
- Department of Health & Human Performance, The University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204, USA
| | - Litty Koshy
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
| | - Maggie Britton
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA; (M.T.); (V.N.); (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (M.B.); (K.D.)
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
| | - Kelli Drenner
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA; (M.T.); (V.N.); (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (M.B.); (K.D.)
| | - Lorraine R. Reitzel
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA; (M.T.); (V.N.); (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (M.B.); (K.D.)
- Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA; (D.P.O.); (L.K.)
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96
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Falcaro M, Osborn D, Hayes J, Coyle G, Couperthwaite L, Weich S, Walters KR. Time trends in access to smoking cessation support for people with depression or severe mental illness: a cohort study in English primary care. BMJ Open 2021; 11:e048341. [PMID: 34862277 PMCID: PMC8647398 DOI: 10.1136/bmjopen-2020-048341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 11/05/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To investigate delivery of smoking cessation interventions, recorded quit attempts and successful quitting rates within primary care in smokers with depression or severe mental illness (SMI) compared with those without. DESIGN Longitudinal cohort study using primary healthcare records. SETTING English primary care. PARTICIPANTS 882 849 patients registered with participating practices recorded as current smokers during 2007-2014, including three groups: (1) 13 078 with SMI, (2) 55 630 with no SMI but recent depression and (3) 814 141 with no SMI nor recent depression. OUTCOMES Recorded advice to quit smoking, referrals to smoking cessation services, prescriptions for smoking cessation medication, recorded quit attempts and changes of smoking status. RESULTS The majority (>70%) of smokers had recorded smoking cessation advice. This was consistently higher in those with SMI than the other cohorts of patients, although the gap greatly reduced in more recent years. Increases in smoking cessation advice over time were not accompanied by increases in recorded attempts to quit or changes of smoking status. Overall nicotine replacement therapy prescribing by general practitioners (GPs) was higher in those with SMI (10.1%) and depression (8.7%) than those without (5.9%), but a downward time trend was observed in all groups. Bupropion and varenicline prescribing was very low and lower for those with SMI. Few smokers (<5%) had referrals to stop smoking services, though this increased over time, but no significant differences were observed between those with and without mental health problems. CONCLUSIONS There was no evidence of consistent inequalities in access to GP-delivered smoking cessation interventions for people with mental health conditions. Smoking cessation advice was widely reported as taking place in all groups. In order to address the widening gap in smoking prevalence in those with poor mental health compared with those without, the emphasis should be on addressing the quality of advice and support given.
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Affiliation(s)
| | - David Osborn
- Faculty of Brain Sciences, University College London, London, UK
| | - Joseph Hayes
- Faculty of Brain Sciences, University College London, London, UK
| | | | | | - Scott Weich
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Kate R Walters
- Department of Primary Care & Population Health, University College London, London, UK
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97
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Bradley T, Bartlem K, Colyvas K, Wye P, Campbell E, Reid K, Bowman J. Examining service participation and outcomes from a population-level telephone-coaching service supporting changes to healthy eating, physical activity and weight: A comparison of participants with and without a mental health condition. Prev Med Rep 2021; 24:101609. [PMID: 34976665 PMCID: PMC8683977 DOI: 10.1016/j.pmedr.2021.101609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/12/2021] [Accepted: 10/17/2021] [Indexed: 10/26/2022] Open
Abstract
Population-level telephone coaching services provide accessible behaviour change support for modifiable health risk behaviours. The NSW Get Healthy Information and Coaching Service® (GHS) is a free telephone-based coaching service in Australia, supporting improvements in healthy eating, physical activity and achieving or maintaining a healthy weight. This study compared measures of participation (such as program completion) and outcomes achieved immediate post-program (including changes in fruit and vegetable consumption, physical activity and weight) for GHS participants with and without a self-identified mental health condition (MHC). Secondary data analysis was conducted on service data collected at program intake and completion for individuals who enrolled in a coaching program between January 2018 and October 2019 (n = 5,629); 33% identified as having had an MHC. While those with and without an MHC had similar rates of completion, those with an MHC were less likely to complete a coaching program (31% vs 36%, p = .003). Participants with an MHC made significant positive changes to their fruit and vegetable consumption, physical activity (walking and moderate), weight and BMI, but not to waist circumference or vigorous physical activity. When comparing the magnitude of change for those with and without an MHC, individuals without made greater improvements to their weight (adjusted mean difference -0.623 kg, p = .034) and daily vegetable intake (adjusted mean difference -0.199 serves; p = .01). There were no differences for other variables. The GHS is an effective means of supporting behaviour change for people with an MHC who complete a coaching program. Further research should consider means of improving retention rates.
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Affiliation(s)
- Tegan Bradley
- University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
| | - Kate Bartlem
- University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
| | - Kim Colyvas
- University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Paula Wye
- University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Elizabeth Campbell
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia
| | - Kate Reid
- NSW Office of Preventive Health, Liverpool Hospital, Don Everett Building, Locked Bag 7103, Liverpool BC, NSW 1871, Australia
| | - Jenny Bowman
- University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
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98
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Olson R, McLay M, Hamm J, Callaghan RC. Identification of Tobacco-Related Cancer Diagnoses among Individuals with Psychiatric Disorders: A Population-Based Matched Cohort Study Using a Competing Risks Approach from British Columbia. Curr Oncol 2021; 28:4953-4960. [PMID: 34898588 PMCID: PMC8628717 DOI: 10.3390/curroncol28060415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/15/2021] [Accepted: 11/20/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Individuals with psychiatric disorders (PD) have a high prevalence of tobacco use. Therefore, we assessed the hazard of receiving a tobacco-related (TR) cancer diagnosis among individuals with PD. METHODS Several population-based provincial databases were used to identify individuals in BC diagnosed with depression, schizophrenia, bipolar disorder, anxiety disorders, or multiple PD between 1990 and 2013. A primary population proxy comparison group (appendicitis) was also identified and matched to the psychiatric cohort based on age at cohort entry, gender, year of cohort entry, and postal code. We linked individuals in the cohort and comparison groups with the BC Cancer Registry. Using a competing risks approach, we estimated the effect of having a PD on the risk of receiving a TR cancer diagnosis, in light of the competing risk of mortality. RESULTS In total, 165,289 patients were included. Individuals with depression (HR = 0.81; p < 0.01; 95% CI: 0.73-0.91), anxiety disorders (HR = 0.84; p = 0.02; 95% CI: 0.73-0.97), or multiple PD (HR = 0.74; p < 0.01; 95% CI: 0.66-0.83) had a statistically significant lower risk of a TR cancer diagnosis compared to the comparison group. Individuals with schizophrenia (HR = 0.86; p = 0.40; 95% CI: 0.62-1.21) or bipolar disorder (HR = 0.58; p = 0.12; 95% CI: 0.29-1.14), however, showed no evidence of a statistically significant difference from the comparison group. INTERPRETATION We found that individuals with depression, anxiety disorders, or multiple PD diagnoses had a significantly reduced risk of receiving a tobacco-related cancer diagnosis. These results were unexpected and could be explained by individuals with a PD having barriers to a cancer diagnosis rather than a true decreased incidence.
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Affiliation(s)
- Robert Olson
- Department of Radiation Oncology, BC Cancer—Prince George, 1215 Lethbridge Street, Prince George, BC V2M 7E9, Canada
- Department of Surgery, Division of Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Northern Medical Program, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada;
| | - Mary McLay
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Jeremy Hamm
- Department of Statistics, BC Cancer—Vancouver, Vancouver, BC V5Z 4E6, Canada;
| | - Russell C. Callaghan
- Northern Medical Program, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada;
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99
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Mistry SK, Ali ARMM, Yadav UN, Huda MN, Ghimire S, Rahman MA, Reza S, Huque R, Rahman MA. Perceived Change in Tobacco Use and Its Associated Factors among Older Adults Residing in Rohingya Refugee Camps during the COVID-19 Pandemic in Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312349. [PMID: 34886073 PMCID: PMC8657143 DOI: 10.3390/ijerph182312349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 12/13/2022]
Abstract
This study explored the perceived change in tobacco use during the COVID-19 pandemic and its associated factors among older adults residing in Rohingya refugee camps, also referred to as Forcibly Displaced Myanmar Nationals in Bangladesh. The study followed a cross-sectional design and was conducted in October 2020 among 416 older adults aged 60 years and above. A purposive sampling technique was applied to identify eligible participants, and face-to-face interviews were conducted using a pre-tested semi-structured questionnaire to collect the data. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic. Binary logistic regression models determined the factors associated with the perceived change in tobacco use. More than one in five participants (22.4%) were current tobacco users, of whom 40.8% reported a perceived increase in tobacco use during the COVID-19 pandemic. Adjusted analysis revealed that participants who were concerned about COVID-19 had significantly (p < 0.05) lower odds of perceived increase in tobacco use (aOR = 0.22, 95% CI: 0.06–0.73), while older adults who were overwhelmed by COVID-19 (aOR = 0.26, 95% CI: 0.06–1.18) and communicated less frequently with others during the pandemic than before (aOR = 0.19, 95% CI: 0.03–1.20) had marginally significantly (p < 0.1) lower odds of perceived increase in tobacco use during this pandemic. Relevant stakeholders, policymakers, and practitioners need to focus on strengthening awareness-raising initiatives as part of an emergency preparedness plan to control tobacco use during such a crisis period.
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Affiliation(s)
- Sabuj Kanti Mistry
- ARCED Foundation, Dhaka 1216, Bangladesh;
- Centre for Primary Health Care and Equity, University of New South Wales, Kensington, NSW 2052, Australia;
- BRAC James P Grant School of Public Health, BRAC University, Dhaka 1213, Bangladesh
- Department of Public Health, Daffodil International University, Dhaka 1207, Bangladesh
- Correspondence: ; Tel.: +61-4068-63358
| | - ARM Mehrab Ali
- ARCED Foundation, Dhaka 1216, Bangladesh;
- Global Research and Data Support, Innovations for Poverty Action, New Haven, CT 06510, USA
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Kensington, NSW 2052, Australia;
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT 2600, Australia
| | - Md. Nazmul Huda
- School of Health Sciences, Western Sydney University, Sydney, NSW 2560, Australia;
- The School of Liberal Arts and Social Sciences, Independent University, Dhaka 1229, Bangladesh
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH 45056, USA;
| | | | - Sompa Reza
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Rumana Huque
- Department of Economics, University of Dhaka, Dhaka 1000, Bangladesh;
- ARK Foundation, Gulshan, Dhaka 1212, Bangladesh
| | - Muhammad Aziz Rahman
- School of Health, Federation University Australia, Berwick, VIC 3350, Australia;
- Department of Non-Communicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka 1216, Bangladesh
- Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
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100
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Salameh TN, Hall LA, Hall MT, Crawford TN. Cigarette smoking cessation and mental health treatment receipt in a U.S national sample of pregnant women with mental illness. J Nurs Scholarsh 2021; 54:202-212. [PMID: 34750961 DOI: 10.1111/jnu.12731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 10/09/2021] [Accepted: 10/20/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To (1) compare the probability of cigarette smoking cessation for pregnant women with and without past-year mental illness by the trimester of pregnancy; and (2) examine the association between the receipt of past-year mental health treatment and prenatal cigarette smoking cessation among pregnant lifetime-smokers with mental illness. METHODS We conducted secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2008-2014. The NSDUH included 2019 pregnant lifetime smokers aged 18-44 years, 528 of whom had a mental illness. We used multiple logistic regression to model the probability of prenatal cigarette smoking cessation. RESULTS Pregnant lifetime-smokers with mental illness had a lower rate of cigarette smoking cessation than women without mental illness (47.9% vs. 61.7%, p = 0.001). Compared to pregnant women without mental illness, pregnant women with mental illness had a significantly lower odds of smoking cessation in the first trimester (Adjusted Odds Ratio [AOR]: 0.34, 95% Confidence Interval [CI]: 0.18-0.66), but not in the second (AOR: 0.87, 95% CI: 0.46-1.63) and third trimesters (AOR: 0.94, 95% CI: 0.51-1.72). The likelihood of quitting smoking did not differ significantly for pregnant lifetime-smokers with mental illness who received and did not receive mental health treatment (AOR: 1.69, 95% CI: 0.87-3.28). CONCLUSION Pregnant lifetime-smokers with mental illness are less likely to quit smoking than those without mental illness; overall, pregnant women tended to quit smoking as they progressed in their pregnancy. The receipt of mental health treatment was not associated with quitting smoking. Mental health care providers need to screen for cigarette use among pregnant women and strengthen smoking cessation efforts. CLINICAL RELEVANCE Pregnancy presents a unique opportunity for mental health care providers to screen for cigarette use in women with mental illness and support their smoking cessation efforts.
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Affiliation(s)
| | - Lynne A Hall
- School of Nursing, University of Louisville, Louisville, Kentucky, USA
| | - Martin T Hall
- Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | - Timothy N Crawford
- Department of Population and Public Health Sciences, Wright State University, Kettering, Ohio, USA
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