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

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.

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.


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