Smoking Cessation in Individuals With Mental Illness With an 18-Month Program

A new comprehensive 18-month smoking cessation program has shown promising results in helping individuals with severe mental illnesses (SMI) successfully quit smoking, according to a new research published in JAMA Psychiatry. "In individuals with serious mental illness who express a desire to quit smoking within six months, an 18-month intervention involving initial pharmacotherapy and personalized behavioral support for smoking cessation and weight management led to increased tobacco abstinence without notable weight gain," the researchers reported (1^✔ ✔Trusted Source
Effect of a Tobacco Cessation Intervention Incorporating Weight Management for Adults With Serious Mental Illness: A Randomized Clinical Trial

Go to source).

Smoking cessation has been a significant topic in public health for a considerable time; however, recent studies have emphasized its heightened importance for individuals dealing with severe mental illnesses.

A research titled "Do People with Mental Illness Use Tobacco More Often?" published in 2019 reveals the following findings:

• People with mental disorders, particularly serious conditions like schizophrenia and bipolar disorder, exhibit significantly higher smoking rates compared to those without mental disorders.
• Among individuals with mental illness, smoking rates are particularly elevated among young adults, individuals with lower education levels, and those living in poverty.
• The higher prevalence of smoking among individuals with depression and schizophrenia can be attributed to the temporary relief provided by nicotine, which helps alleviate symptoms like poor concentration, low mood, and stress.
• Those with anxiety or substance use disorders also display a greater tendency to use smokeless tobacco products.
• Smoking rates among individuals undergoing addiction treatment are notably high, ranging from 65% to 85%.

Individuals with severe mental illnesses also experience notably increased cardiovascular disease risks as a result of tobacco smoking. Additionally, the detrimental health effects are magnified by the widespread occurrence of overweight and obesity, which is frequently linked to mental health disorders.

Another study titled "Prevalence of Obesity and Overweight in Individuals With Severe Mental Illness" published in 2021 presents the following findings::

• Individuals with SMI experience a considerably higher prevalence of overweight and obesity compared to the general population, regardless of geographical location (2^✔ ✔Trusted Source
  Prevalence of Overweight and Obesity in People With Severe Mental Illness: Systematic Review and Meta-Analysis
  
  Go to source).
• The prevalence of obesity among individuals with SMI varies depending on factors such as geographical region, country income classification, and gender..
• This knowledge gap emphasizes the need for more research in low and middle income countries to better understand and address the prevalence of overweight and obesity among individuals with SMI.

Clinical Trial to Assess Efficacy of Smoking Cessation Program

Dr. Gail Daumit and her team at the Johns Hopkins University School of Medicine conducted a randomized clinical trial to assess the efficacy of an 18-month tobacco smoking cessation program. The intervention incorporated pharmacologic and behavioral elements, including weight management, as part of the evaluation.

The study enrolled daily smokers with serious mental illnesses who may not have been prepared to quit smoking immediately. Based on their readiness to quit smoking within a period of one month or six months, participants were assigned randomly to either the intervention or control group.

The researchers wanted to find out if people who took part in the program were able to stop smoking for at least seven consecutive days after 18 months. They checked this by using special tests to confirm if the participants were tobacco-free. The results were impressive. In the group that received the program, 26.4% of people were able to quit smoking, while in the other group that only got information about quitlines, only 5.7% were able to quit.

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The intervention involved a comprehensive strategy that combined the use of medications like varenicline or nicotine replacement therapy with behavioral support. Participants received personalized counseling both individually and in group settings to help with motivation, quitting smoking, avoiding relapses, managing weight, and staying physically active. On the other hand, the control group only received referrals to quitlines and did not receive the extensive intervention that was given to the intervention group.

Extended Intervention Boosts Smoking Abstinence Rates Sixfold

Importantly, the study discovered that individuals in the intervention group were able to quit smoking without facing significant weight gain. This is noteworthy because weight gain often acts as a hurdle to quitting smoking, especially for those with serious mental illness.

The results showed that people who received the longer treatment program had almost six times higher chances of successfully quitting smoking compared to those who didn't receive the extended treatment.

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The results suggest that individuals who received the extended-duration intervention had almost six times higher chances of successfully abstaining from smoking compared to those in the control group. It is worth noting that the willingness to quit smoking within one month did not have a substantial effect on how well the intervention worked. This indicates that the extended-duration treatment could be beneficial for people who are not quite ready to quit right away but show an interest in doing so within a relatively short period.

The findings of this study have significant implications for individuals with serious mental illness who have high smoking rates and increased risks of cardiovascular disease. By implementing a longer-duration tobacco cessation treatment, healthcare professionals can successfully decrease smoking rates and reduce the risk of cardiovascular disease in this vulnerable group.

It is crucial to acknowledge that these results are derived from an 18-month clinical trial, and additional research is necessary to confirm the long-term effectiveness of the intervention. Nonetheless, the study offers valuable insights into the potential of an effective approach to smoking cessation that caters to the unique requirements of individuals with serious mental illness.

References:

1. Effect of a Tobacco Cessation Intervention Incorporating Weight Management for Adults With Serious Mental Illness: A Randomized Clinical Trial - (https://pubmed.ncbi.nlm.nih.gov/37378972/)
2. Prevalence of Overweight and Obesity in People With Severe Mental Illness: Systematic Review and Meta-Analysis - (https://www.frontiersin.org/articles/10.3389/fendo.2021.769309/full)

Source-Medindia