Quit-Smoking Programs Work for Psychiatric Patients
Study found improved chances of quitting, lower rehospitalization rates
Thursday, August 15, 2013
The findings challenge a common belief among mental-health experts that smoking is a useful tool in treating some psychiatric patients. For example, cigarettes may be used as part of a reward system or doctors may sometimes smoke with patients as a way of creating a connection, said Judith Prochaska, an associate professor at the Stanford University School of Medicine.
Prochaska and her colleagues studied 224 patients at a smoke-free psychiatric hospital in California. All the patients smoked at least five cigarettes a day prior to being admitted to the hospital. The patients had a range of mental-health conditions, including depression, bipolar disorder and schizophrenia. Three-quarters were suicidal. All of the patients were offered nicotine patches or gum during their hospitalization.
The patients were divided into two groups. One group took part in a smoking-cessation program while a control group received usual care. Patients in the control group were given a pamphlet about the hazards of smoking, along with information on how to quit.
The patients in the smoking-cessation program completed a computer-assisted program with individualized feedback, received a print manual, met for 15 to 30 minutes with a counselor and were offered a 10-week supply of nicotine patches if they decided they wanted to quit smoking.
The computer-assisted program was repeated three and six months after patients left the hospital to support patients who wanted to quit smoking, according to the study, which was published online Aug. 15 in the American Journal of Public Health.
Eighteen months after leaving the hospital, 20 percent of those in the treatment group had quit smoking, compared with 7.7 percent of those in the control group. Forty-four percent of patients in the treatment group and 56 percent of those in the control group had been readmitted to the hospital.
The findings show that helping patients quit smoking did not harm their mental-health recovery and may have even improved it, Prochaska said.
"I think some of the therapeutic contact that addressed participants' tobacco dependence, and supported them with this major health goal, may have generalized to them feeling better about their mental-health condition," Prochaska said in a Stanford news release.
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