Search

Background : Tobacco-related morbidity and mortality is high among people with mental illnesses (PMI); yet tobacco treatment (TT) is often not provided by mental health care providers (MHPs). Studies that examine barriers to TT for people with MI are critical in addressing this disparity. Aims : To determine factors associated with MHPs' opinions of, self-efficacy in, barriers to and training needs for providing TT by job role. Methods : 205 MHPs in a psychiatric facility were surveyed using a standardized questionnaire on demographics and opinions, self-efficacy, barriers and needs to providing TT. Descriptive and multivariate regression analyses examined factors associated with the main outcomes. Results : MHP's gave high ratings to both the appropriateness of delivering evidence-based TT and their confidence in providing TT medications. In regards to perceived barriers to providing TT, MHP's further endorsed that patients should be provided nicotine replacement therapy and be motivated to engage in TT. Key needs were for training in cessation counseling, cessation materials and community support for TT. Conclusions : Based on our findings, future studies are needed to address providers' biases and concerns, eliminate system-barriers and determine effective provider training. Moreover, these findings may guide research, practice and policies toward enhancing TT in PMI.

People with schizophrenia and other psychotic disorders (PWS) consume tobacco at high rates, resulting in disproportionate tobacco-related morbidity and mortality. Conventional tobacco treatment (TT) approaches may not adequately address unique affective, cognitive, and social challenges of PWS during cessation. This study sought to obtain provider and mental health consumer perspectives on effective, desirable, applicable, and acceptable components of TT for PWS. This convergent mixed-method study used structured interviews and a cross-sectional survey to obtain data. Eighteen mental health consumers and six mental health providers were engaged in face-to-face or telephone interviews. The qualitative data were analyzed using content analysis and theme identification and descriptive statistics were used for the analysis of quantitative data. In the qualitative analysis, consumers endorsed education, counseling, social support, and pharmacotherapy as key TT components. Consumers further stressed the need for flexible interventions that are available at any point in a quit attempt. Both providers and consumers endorsed targeting TT interventions to consider learning needs, potential cognitive issues, and motivation for behavioral change. Providers encouraged a recovery-driven TT framework with peer support and health promotion activities. Quantitative findings mirrored the qualitative findings with support sessions, relapse prevention, and skills training having the highest desirability, applicability, and acceptability TT component scores. Providers and consumers agreed on components of an effective TT program targeted to PWS. Given these findings, it is crucial to further investigate successful TT approaches for PWS and to test whether targeted or tailored programs are more effective than conventional approaches.

Introduction: Secondhand smoke exposure (SHSe) is predictive of greater nicotine dependence (ND) and poor smoking cessation (SC) outcomes. SHSe and its impact on ND and SC attempts in people with psychiatric disorders (PD) remain poorly understood. Hence, the objectives of this study were to (1) quantify SHSe, (2) examine the association of SHSe with ND, and (3) assess the association between SHSe and SC among tobacco users with PD., Method: A cross-sectional survey of 118 tobacco users in an inpatient psychiatric facility was conducted. Data on demographics, tobacco use and SHSe history, motivation to quit smoking, ND, and SC attempts were obtained. Participants' environmental and psychosocial sources of and perceived SHSe were described. Multivariate linear regression analyses were used to examine the associations between SHSe and ND, while logistic regression analyses were used to assess the associations between SHSe and SC., Results: The primary sources of environmental SHSe were from the car (63.6%) and home (51.7%); primary sources of psychosocial SHSe were close friends (67.8%) and parents/grandparents (65.3%); and mean perceived SHSe was 6.2 ( SD = 3.5). Although perceived SHSe was significantly associated with ND (β = .39, p < .0001) in multivariate analyses, no SHSe variable was associated with SC. However, scores on items measuring motivation to quit smoking were associated with SC attempts., Discussion: Patients with PD reported high levels of SHSe, which was associated with higher ND. Routine screening for SHSe should be implemented as part of health assessments in this population to address ND treatment options. Moreover, targeted interventions and policies should be considered toward reducing SHSe in this vulnerable population.