Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan 28;1(1):CD009704.
doi: 10.1002/14651858.CD009704.pub2.

Smoking cessation advice for people with serious mental illness

Priya Khanna  1 , Andrew V Clifton, David Banks, Graeme E Tosh
Affiliations

Smoking cessation advice for people with serious mental illness

Priya Khanna et al. Cochrane Database Syst Rev. .

Abstract

Background: People with a serious mental illness are more likely to smoke more and to be more dependent smokers than the general population. This may be due to a wide range of factors that could include a common aetiology to both smoking and the illness, self medication, smoking to alleviate adverse effects of medications, boredom in the existing environment, or a combination of these factors. It is important to undertake this review to facilitate improvements in both the health and safety of people with serious mental illness who smoke, and to reduce the overall burden of costs (both financial and health) to the smoker and, eventually, to the taxpayer.

Objectives: To review the effects of smoking cessation advice for people with serious mental illness.

Search methods: We searched the Cochrane Schizophrenia Group Specialized Trials Register up to 2 April 2015, which is based on regular searches of CENTRAL, BIOSIS, PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, and trial registries. We also undertook unsystematic searches of a sample of the component databases (BNI, CINHAL, EMBASE, MEDLINE, and PsycINFO), up to 2 April 2015, and searched references of all identified studies

Selection criteria: We planned to include all randomised controlled trials (RCTs) that focussed on smoking cessation advice versus standard care or comparing smoking cessation advice with other more focussed methods of delivering care or information.

Data collection and analysis: The review authors (PK, AC, and DB) independently screened search results but did not identify any trials that fulfilled the inclusion criteria of this review.

Main results: We did not identify any RCTs that evaluated advice regarding smoking cessation for people with serious mental illness. The excluded studies illustrate that randomisation of packages of care relevant to smokers with serious mental illness is possible.

Authors' conclusions: People with serious mental illness are more likely to smoke than the general population. Yet we could not find any high quality evidence to guide the smoking cessation advice healthcare professionals pass onto service users. This is an area where trials are possible and needed.

PubMed Disclaimer

Conflict of interest statement

Priya Khanna has no known conflicts of interest. Andrew Clifton has no known conflicts of interest. David Banks has no known conflicts of interest. Graeme Tosh has no known conflicts of interest.

Figures

1
1
AMA Family Medical Guide 2004: The risks of smoking.
2
2
AMA Family Medical Guide 2004; Mortality risks from smoking.
3
3
Study flow diagram for trial selection.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD009704

References

References to studies excluded from this review

Baker 2006 {published data only}
    1. Baker A, Richmond R, Haile M, Lewin TJ, Carr VJ, Taylor RL, et al. A randomized controlled trial of a smoking cessation intervention among people with a psychotic disorder. The American Journal of Psychiatry 2006;163(11):1934‐42. [PUBMED: 17074945] - PubMed
Brown 2009 {published data only}
    1. Brown RA, Strong DR, Abrantes AM, Myers MG, Ramsey SE, Kahler CW. Effects on substance use outcomes in adolescents receiving motivational interviewing for smoking cessation during psychiatric hospitalization. Addictive Behaviors 2009;34(10):887‐91. [PUBMED: 19342179] - PMC - PubMed
Ziedonis 1997 {published data only}
    1. Ziedonis DM, George TP. Schizophrenia and nicotine use: report of a pilot smoking cessation program and review of neurobiological and clinical issues. Schizophrenia Bulletin 1997;23(2):247–54. [PUBMED: 9165635] - PubMed

References to ongoing studies

NCT00500695 {published data only}
    1. NCT00500695. Enhancing Motivation To Quit Smoking In Smokers With Serious Mental Illness. https://clinicaltrials.gov/ct2/show/NCT00500695 (accessed April 2015). [NCT00500695]

Additional references

Altman 1996
    1. Altman DG, Bland JM. Detecting skewness from summary information. BMJ 1996;313(7066):1200. [PUBMED: 8916759] - PMC - PubMed
AMA Family Medical Guide 2004
    1. American Medical Association. Family Medical Guide. Wiley, 2004. [978‐0471269113]
Banham 2010
    1. Banham L, Gilbody S. Smoking cessation in severe mental illness: what works?. Addiction 2010;105(7):1176‐89. [PUBMED: 20491721] - PubMed
Bland 1997
    1. Bland JM. Statistics notes. Trials randomised in clusters. BMJ 1997;315(7108):600. [PUBMED: 9302962] - PMC - PubMed
Boissel 1999
    1. Boissel JP, Cucherat M, Li W, Chatellier G, Gueyffier F, Buyse M, et al. The problem of therapeutic efficacy indices. 3. Comparison of the indices and their use [Apercu sur la problematique des indices d'efficacite therapeutique, 3: comparaison des indices et utilisation. Groupe d'etude des indices d'efficacite]. Thérapie 1999;54(4):405‐11. [PUBMED: 10667106] - PubMed
Cournos 2005
    1. Cournos F, McKinnon K, Sullivan G. Schizophrenia and comorbid human immunodeficiency virus or hepatitis C virus. Journal of Clinical Psychiatry 2005;66 Suppl 6:27‐33. [PUBMED: 16107181] - PubMed
Deeks 2000
    1. Deeks J. Issues in the selection for meta‐analyses of binary data. Proceedings of the 8th International Cochrane Colloquium; 2000 Oct 25‐28; Cape Town. Cape Town: The Cochrane Collaboration, 2000.
Divine 1992
    1. Divine GW, Brown JT, Frazier LM. The unit of analysis error in studies about physicians' patient care behavior. Journal of General Internal Medicine 1992;7(6):623‐9. [PUBMED: 1453246] - PubMed
Dixon 1999
    1. Dixon L, Postrado L, Delahanty J, Fischer PJ, Lehman A. The association of medical comorbidity in schizophrenia with poor physical and mental health. Journal of Nervous and Mental Disease 1999;187(8):496‐502. [PUBMED: 10463067] - PubMed
Docherty 1999
    1. Docherty B. Care in the community. Fire Prevention 1999;317:26‐7.
DoH 2004
    1. Department of Health. Summary of Intelligence on Tobacco. Department of Health. 2004. http://www.erpho.org.uk/Download/Public/11077/1/WP%20Summary%20doc.pdf (accessed 1st March 2011):1‐4.
Donner 2002
    1. Donner A, Klar N. Issues in the meta‐analysis of cluster randomized trials. Statistics in Medicine 2002;21(19):2971‐80. [PUBMED: 12325113] - PubMed
Egger 1997
    1. Egger M, Davey‐Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315(7109):629‐34. [PUBMED: 9310563] - PMC - PubMed
Elbourne 2002
    1. Elbourne D, Altman DG, Higgins JPT, Curtin F, Worthington HV, Vail A. Meta‐analyses involving cross‐over trials: Methodological issues. International Journal of Epidemiology 2002;31(1):140‐9. [PUBMED: 11914310] - PubMed
Ford 2013
    1. Ford J. The NHS is facing a deepening financial crisis. BMJ (Clinical research ed.) 2013;347:f4422. [PUBMED: 23843501] - PubMed
Greenlund 2002
    1. Greenlund KJ, Giles WH, Keenan NL, Croft JB, Mensah GA. Physician advice, patient actions, and health‐related quality of life in secondary prevention of stroke through diet and exercise. Stroke 2002;33(2):565‐70. [PUBMED: 11823671] - PubMed
Gulliford 1999
    1. Gulliford MC, Ukoumunne OC, Chinn S. Components of variance and intraclass correlations for the design of community‐based surveys and intervention studies: data from the Health Survey for England 1994. American Journal of Epidemiology 1999;149(9):876‐83. [PUBMED: 10221325] - PubMed
Health Development Agency 2004
    1. Health Development Agency. Smoking and patients with mental health problems. 2004. http://www.nice.org.uk/proxy/?sourceUrl=http%3A%2F%2Fwww.nice.org.uk%2Fn... (accessed 1st March 2011):1‐16.
Higgins 2003
    1. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. [PUBMED: 12958120] - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Kay 1986
    1. Kay SR, Opler LA, Fiszbein A. Positive and Negative Syndrome Scale (PANSS) Manual. North Tonawanda, New York: Multi‐Health Systems, 1986.
Khokhar 2011
    1. Khokhar WA, Clifton A, Jones H, Tosh G. Oral health advice for people with serious mental illness. Cochrane Database of Systematic Reviews 2011, Issue 11. [DOI: 10.1002/14651858.CD008802.pub2] - DOI - PubMed
Kreuter 2000
    1. Kreuter MW, Chheda SG, Bull FC. How does physician advice influence patient behavior? Evidence for a priming effect. Archives of Family Medicine 2000;9(5):426‐33. [PUBMED: 10810947] - PubMed
Leucht 2005a
    1. Leucht S, Kane JM, Kissling W, Hamann J, Etschel E, Engel R. Clinical implications of Brief Psychiatric Rating Scale scores. British Journal of Psychiatry 2005;187:366‐71. [PUBMED: 16199797] - PubMed
Leucht 2005b
    1. Leucht S, Kane JM, Kissling W, Hamann J, Etschel E, Engel RR. What does the PANSS mean?. Schizophrenia Research 2005;79(2‐3):231‐8. [PUBMED: 15982856] - PubMed
Leucht 2007
    1. Leucht S, Engel RR, Bäuml J, Davis JM. Is the superior efficacy of new generation antipsychotics an artifact of LOCF?. Schizophrenia Bulletin 2007;33(1):183‐91. [PUBMED: 16905632] - PMC - PubMed
Marshall 2000
    1. Marshall M, Lockwood A, Bradley C, Adams CE, Joy C, Fenton M. Unpublished rating scales: a major source of bias in randomised controlled trials of treatments for schizophrenia. British Journal of Psychiatry 2000;176:249‐52. [PUBMED: 10755072] - PubMed
McCreadie 2000
    1. McCreadie RG, Kelly C. Patients with schizophrenia who smoke. Private disaster, public resource. British Journal of Psychiatry 2000;176:109. [PUBMED: 10755044] - PubMed
McDonald 2000
    1. McDonald C. Cigarette smoking in patients with schizophrenia. British Journal of Psychiatry 2000;176:596‐7. [PUBMED: 10974973] - PubMed
Meltzer 1996
    1. Meltzer H, Gill B, Petticrew M. Economic activity and social functioning of residents with psychiatric disorders. OPCS Surveys of Psychiatric Morbidity in Great Britain, Report 6. London: HMSO, 1996.
Newman 1991
    1. Newman SC, Bland RC. Mortality in a cohort of patients with schizophrenia: a record linkage study. Canadian Journal of Psychiatry 1991;36(4):239‐45. [PUBMED: 1868416] - PubMed
NHS 2011
    1. NHS Smokesfree. NHS Stop Smoking Services. Service and monitoring guidance 2010/11. http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.go... (accessed 1st March 2011).
NICE 2006
    1. National Institute for Health and Clinical Excellence. Brief interventions and referral for smoking cessation in primary care and other settings. March 2006. https://www.nice.org.uk/guidance/ph1/chapter/recommendations (accessed 1st March 2011).
NICE 2011
    1. National Institute for Health and Clinical Excellence. Psychosis with coexisting substance misuse. Assessment and management in adults and young people. NICE Clinical Guidelines, No. 120. March 2011. http://www.ncbi.nlm.nih.gov/books/NBK109783/pdf/Bookshelf_NBK109783.pdf (accessed 1st March 2011). - PubMed
NIMH 1987
    1. National Institute of Mental Health. Towards a Model for a Comprehensive Community‐Based Mental Health System. Washington, DC: National Institute of Mental Health, 1987.
Overall 1962
    1. Overall JE, Gorham DR. The brief psychiatric rating scale. Psychological Reports 1962;10(3):799‐812.
Peto 2006
    1. Peto R, Lopez AD, Boreham J, Thun M. Mortality From Smoking in Developed Countries 1950‐2000. 2nd Edition. Oxford: Oxford University Press, 2006.
Phelan 2001
    1. Phelan M, Stradins L, Morrison S. Physical health of people with severe mental illness. BMJ 2001;322(7284):443‐4. [PUBMED: 11222406] - PMC - PubMed
Robson 2007
    1. Robson D, Gray R. Serious mental illness and physical health problems: a discussion paper. International Journal of Nursing Studies 2007;44(3):457‐66. [PUBMED: 17007859] - PubMed
Ruggeri 2000
    1. Ruggeri M, Leese M, Thornicroft G, Bisoffi G, Tansella M. Definition and prevalence of severe and persistent mental illness. British Journal of Psychiatry 2000;177:149‐55. [PUBMED: 11026955] - PubMed
Russell 1979
    1. Russell MA, Wilson C, Taylor C, Baker CD. Effect of general practitioners' advice against smoking. British Medical Journal 1979;2(6184):231‐5. [PUBMED: 476401] - PMC - PubMed
Schinnar 1990
    1. Schinnar AP, Rothbard AB, Kanter R, Jung YS. An empirical literature review of definitions of severe and persistent mental illness. American Journal of Psychiatry 1990;147(12):1602‐8. [PUBMED: 2244636] - PubMed
Schünemann 2008
    1. Schünemann HJ, Oxman AD, Vist GE, Higgins JPT, Deeks JJ, Glasziou P, et al. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Chichester: The Cochrane Collaboration, 2008:359‐83.
Stott 1990
    1. Stott NC, Pill RM. 'Advise yes, dictate no'. Patients' views on health promotion in the consultation. Family Practice 1990;7(2):125‐31. [PUBMED: 2369980] - PubMed
Sutherland 2003
    1. Sutherland G. Smoking: can we really make a difference?. Heart 2003;89 Suppl 2:ii25‐7; discussion ii35‐7. [PUBMED: 12695432] - PMC - PubMed
Tosh 2014a
    1. Tosh G, Clifton AV, Xia J, White MM. Physical health care monitoring for people with serious mental illness. Cochrane Database of Systematic Reviews 2014, Issue 1. [DOI: 10.1002/14651858.CD008298.pub3] - DOI - PMC - PubMed
Tosh 2014b
    1. Tosh G, Clifton AV, Xia J, White MM. General physical health advice for people with serious mental illness. Cochrane Database of Systematic Reviews 2014, Issue 3. [DOI: 10.1002/14651858.CD008567.pub3] - DOI - PMC - PubMed
Tsoi 2013
    1. Tsoi DT, Porwal M, Webster AC. Interventions for smoking cessation and reduction in individuals with schizophrenia. Cochrane Database of Systematic Reviews 2013, Issue 2. [DOI: 10.1002/14651858.CD007253.pub3] - DOI - PMC - PubMed
Ukoumunne 1999
    1. Ukoumunne OC, Gulliford MC, Chinn S, Sterne JAC, Burney PGJ. Methods for evaluating area‐wide and organisation‐based intervention in health and health care: a systematic review. Health Technology Assessment 1999;3(5):iii‐92. [PUBMED: 10982317] - PubMed
WHO 2011
    1. World Health Organization. WHO Report on the Global Tobacco Epidemic, 2011: Warning about the dangers of tobacco. http://apps.who.int/iris/bitstream/10665/44616/1/9789240687813_eng.pdf (accessed 1st March 2011).
Wright 2014
    1. Wright N, Akhtar A, Tosh G, Clifton A. HIV prevention advice for people with serious mental illness. Cochrane Database of Systematic Reviews 2014, Issue 12. [DOI: 10.1002/14651858.CD009639.pub2] - DOI - PubMed
Xia 2009
    1. Xia J, Adams CE, Bhagat N, Bhagat V, Bhoopathi P, El‐Sayeh H, et al. Loss to outcomes stakeholder survey: the LOSS study. Psychiatric Bulletin 2009;33(7):254‐7.
Zimmerman 1994
    1. Zimmerman M. Diagnosing personality disorders. A review of issues and research methods. Archives of General Psychiatry 1994;51(3):225‐45. [PUBMED: 8122959] - PubMed

References to other published versions of this review

Khanna 2012
    1. Khanna P, Clifton A, Banks D, Tosh G. Smoking cessation advice for people with serious mental illness. Cochrane Database of Systematic Reviews 2012, Issue 3. [DOI: 10.1002/14651858.CD009704] - DOI - PMC - PubMed

Publication types

LinkOut - more resources