Addiction Disorders

Many Individuals With Serious Mental Illness Successfully Quit Smoking With a Scalable, Multicomponent Intervention Program

Jessica Nye, PhD
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The study authors sought to determine if a brief, multicomponent, sustained care smoking cessation intervention tailored to individuals with severe mental illness can facilitate treatment engagement and abstinence following hospital discharge.

A scalable, multicomponent smoking cessation intervention for individuals with serious mental illness (SMI) was found to be more effective than standard care. These findings were published in JAMA Psychiatry.

Patients (N=342) with SMI who were undergoing freestanding, acute-care treatment at the University of Texas at Austin and smoked ³5 cigarettes per day were recruited between 2015 and 2019 for the Helping HAND 3 clinical trial. Randomization occurred in a 1:1 ratio to receive sustained care (SusC; n=169) or usual care (n=173). SusC comprised of a 40-minute motivational interview-based counseling session, specifically adapted for an SMI patient population. Participants received a telephone number which they could call and received 5 proactive phone calls over 3 months, and 4 weeks of transdermal nicotine patches.

Study participants were aged mean 35.8 (standard deviation [SD], 12.3) years, 78.4% were White, and 49.4% were women. Among the SusC and control groups, the most common psychiatric diagnoses were depressive disorders (49.1% vs 48.6%), bipolar disorder (28.4% vs 31.2%), substance-associated and addictive disorders (38.5% vs 43.4%), and personality disorders (14.8% vs 13.3%), respectively.

At 6 months, 23.7% of the intervention group and 13.2% of the control cohort had biochemically or significant other verified smoking cessation. The SusC program associated with increased likelihood of quitting smoking (adjusted odds ratio [aOR], 2.08; 95% CI, 1.05-4.10; P =.04).

At 6 months, participants in the SusC group were more likely to use medication (71.0% vs 37.0%; relative risk [RR], 1.92; 95% CI, 1.54-2.38; P <.001) and counseling (37.3% vs 11.0%; RR, 3.39; 95% CI, 2.13-5.42; P <.001) than the control group to aid in their smoking cessation.

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This study comprised patients with limited ethnic diversity and the investigators reported significant challenges in obtaining biochemical verification of smoking cessation among many participants.

These data confirmed that a multicomponent smoking cessation program was effective at promoting smoking abstinence among individuals who had an SMI.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Brown RA, Minami H, Hecht J, et al. Sustained care smoking cessation intervention for individuals hospitalized for psychiatric disorders: The Helping HAND 3 randomized clinical trial. JAMA Psychiatry. Published online May 5, 2021. doi:10.1001/jamapsychiatry.2021.0707