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Randomized Controlled Trial
. 2025 Jul 25;20(1):29.
doi: 10.1186/s13011-025-00663-9.

Clearing the smoke: experiences of patients and professionals during a one-year smoking cessation intervention in ambulatory mental healthcare - a qualitative study

Müge H Küçükaksu  1 , Lola Jansen  2 , Trynke Hoekstra  2 , Sanne Helmig  2   3 , Marcel C Adriaanse  2 , Berno van Meijel  4   5   6
Affiliations
Randomized Controlled Trial

Clearing the smoke: experiences of patients and professionals during a one-year smoking cessation intervention in ambulatory mental healthcare - a qualitative study

Müge H Küçükaksu et al. Subst Abuse Treat Prev Policy. .

Abstract

Background: To further develop effective smoking cessation interventions within mental healthcare for people with severe mental illness (SMI), it is essential to gain insights into patients' experiences with smoking (cessation), and professionals' experiences with guiding patients in overcoming tobacco addiction.

Methods: We conducted 26 semi-structured interviews with 16 patients and 10 mental healthcare professionals (MHPs), as part of a one-year smoking cessation intervention. A purposive sampling strategy was applied to select the interviewees. All interviews were transcribed verbatim and thematically analysed using MAXQDA software. This study was embedded in a randomised controlled trial conducted in ambulatory mental healthcare in the Netherlands.

Results: Patients reported to smoke to cope with psychological distress and psychiatric symptoms, and to alleviate potential side effects of antipsychotic medication. For some patients low self-esteem and a lack of confidence in one's own capacity to quit smoking were obstacles to a quit attempt. Therefore, for those patients these were crucial aspects to address. Patients and MHPs valued the exercises based on cognitive behavioural therapy (CBT). During group sessions, establishing personalised relapse prevention strategies was regarded as effective preparation for a quit attempt. The group setting was welcomed, however, adjustments to individual needs and preferences are required to personalise the intervention.

Conclusions: Findings highlight the need for personalised care in treating tobacco addiction among people with severe mental illness. The KISMET intervention may serve as a useful framework for tailored cessation support, informed by the diverse experiences presented in this study.

Keywords: Ambulatory mental healthcare; Severe mental illness; Smoking cessation; Thematic analyses; Tobacco addiction.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in line with the Declaration of Helsinki, the Dutch Medical Research Involving Human Subjects Act (WMO), and the General Data Protection Regulation (GDPR). It has been approved by the Medical Ethical Committee of the University Medical Centres in Amsterdam, Netherlands (NL76469.029.21, registered under 2021.0158). The main trial is registered in the Dutch trial register (NL-OMON54435). All participants were informed about the study aim, their right to stop the interview at any time and gave written consent by signing an informed consent. Patients received a 10-euro voucher for their participation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

References

    1. WHO, Tobacco. 2022 [Available from: https://www.who.int/en/news-room/fact-sheets/detail/tobacco
    1. Taylor GM, Sawyer K, Kessler D, Munafò MR, Aveyard P, Shaw A. Views about integrating smoking cessation treatment within psychological services for patients with common mental illness: a multi-perspective qualitative study. Health Expect. 2021;24(2):411–20. - PMC - PubMed
    1. Chen L-S, Baker T, Brownson RC, Carney RM, Jorenby D, Hartz S, et al. Smoking cessation and electronic cigarettes in community mental health centers: patient and provider perspectives. Commun Ment Health J. 2017;53:695–702. - PMC - PubMed
    1. Brown CH, Medoff D, Dickerson FB, Fang LJ, Lucksted A, Goldberg RW, et al. Factors influencing implementation of smoking cessation treatment within community mental health centers. J Dual Diagnosis. 2015;11(2):145–50. - PMC - PubMed
    1. Kertes J, Stein Reisner O, Grunhaus L, Nezry R, Alcalay T, Azuri J, Neumark Y. Comparison of smoking cessation program registration, participation, smoking cessation medication utilization, and abstinence rates between smokers with and without schizophrenia, Schizo-affective disorder, or bipolar disorder. Nicotine Tob Res. 2022;24(5):670–8. - PubMed

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