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Introduction:E-cigarettes can be categorized into two basic types, (1) cigalikes, that are disposable or use pre-filled cartridges and (2) tanks, that can be refilled with liquids. The aims of this study were to examine: (1) predictors of using the two e-cigarette types, and (2) the association between type used, frequency of use (daily vs. non-daily vs. no use), and quitting.Methods:Online longitudinal survey of smokers in Great Britain was first conducted in November 2012. Of 4064 respondents meeting inclusion criteria at baseline, this study included (N = 1643) current smokers followed-up 1 year later. Type and frequency of e-cigarette use were measured at follow-up.Results:At follow-up, 64% reported no e-cigarette use, 27% used cigalikes, and 9% used tanks. Among e-cigarette users at follow-up, respondents most likely to use tanks versus cigalikes included: 40–54 versus 18–24 year olds and those with low versus moderate/high education. Compared to no e-cigarette use at follow-up, non-daily cigalike users were less likely to have quit smoking since baseline (P = .0002), daily cigalike or non-daily tank users were no more or less likely to have quit (P = .3644 and P = .4216, respectively), and daily tank users were more likely to have quit (P = .0012).Conclusions:Whether e-cigarette use is associated with quitting depends on type and frequency of use. Compared with respondents not using e-cigarettes, daily tank users were more likely, and non-daily cigalike users were less likely, to have quit. Tanks were more likely to be used by older respondents and respondents with lower education.

Citation: Robson, D., Haddad, M., Gray, R. & Gournay, K. (2013). Mental health nursing and physical health care: a cross-sectional study of nurses' attitudes, practice, and perceived training needs for the physical health care of people with severe mental illness. International Journal Of Mental Health Nursing, 22(5), pp. 409-417. doi: 10.1111/j.1447-0349.2012.00883.x This is the accepted version of the paper.This version of the publication may differ from the final published version. University of East Anglia, Norwich, UK *These authors contributed equally to this study. Permanent AbstractMental health nurses have a key role in improving the physical health of people with a serious mental illness, however there have been few studies of their attitudes or the extent of their involvement in this work. The aim of this study was to examine mental health nurses' attitudes to physical healthcare and explore associations with their practice and training.A postal questionnaire survey including the Physical Health Attitude Scale for mental health nurses (PHASe) was used within a UK mental health trust. The 52% (n=585) of staff who responded reported varying levels of physical health practice; this most frequently involved providing dietary and exercise advice and less frequently included advice re cancer screening and smoking cessation. Having received post-registration physical healthcare training and working in in-patient settings was associated with greater reported involvement. More positive attitudes were also evident for nurses who had attended post-registration physical health training or had an additional adult/general nursing qualification.Overall, the attitudes of mental health nurses towards physical health care appear positive and the willingness of nurses to take on these roles needs to be recognised. However there are areas where nurses in our sample were more ambivalent such as cancer screening and smoking cessation.

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One of the major clinical problems in the treatment of people with schizophrenia is suboptimal medication adherence. Most research focusing on determinants of nonadherence use quantitative research methods. These studies have some important limitations in exploring the decision-making process of patients concerning medication. In this study we explore factors influencing medication adherence behavior in people with schizophrenia using concept mapping. Concept mapping is a structured qualitative method and was performed in 4 European countries. Participants were 27 patients with schizophrenia, 29 carers, and 28 professionals of patients with schizophrenia. Five clinically relevant themes were identified that affect adherence: medication efficacy, external factors (such as patient support and therapeutic alliance), insight, side effects, and attitudes toward medication. Importance ratings of these factors differed significantly between professionals and carers and patients. Professionals, carers, and patients do not have a shared understanding of which factors are important in patients' medication adherence behavior. Adherence may be positively influenced if professionals focus on the positive aspects of medication, on enhancing insight, and on fostering a positive therapeutic relationship with patients and carers.

Citation: Robson, D. & Haddad, M. (2012). Mental health nurses' attitudes towards the physical health care of people with severe and enduring mental illness: The development of a measurement tool. International Journal of Nursing Studies, 49(1), pp. 72-83. doi: 10.1016/j.ijnurstu.2011.07.011 This is the unspecified version of the paper.This version of the publication may differ from the final published version. Results: A 28-item measure comprised of four factors accounted for 42% of the variance. The factor solution appeared to provide meaningful dimensions, and the internal consistency of the measure and of its derived subscales was adequate (Cronbach's alpha between 0.76 and 0.61). The factors were labelled nurses' attitudes to involvement in physical health care; nurses' confidence in delivering physical health care; perceived barriers to physical health care delivery and nurses' attitudes to smoking. Validity was established by associations between the total scale and subscales with predetermined respondent variables. Permanent Conclusion:The Physical Health Attitude Scale for mental health nurses (PHASe) is a first attempt to develop a valid and reliable measure of this important area. The initial development methods and its testing in a large sample provide indications of content and construct validity. Further testing in different samples and consequent refinement are necessary, however the PHASe appears to be a useful tool for measuring attitudes among this professional group and evaluating the effects of professional development.

Adherence therapy has a positive impact on patients' psychiatric symptoms, attitude towards and satisfaction with medication. Nurses can effectively deliver adherence therapy following intensive training.

Background and aims To assess the efficacy and tolerability of adjunctive pharmacotherapy for smoking cessation in adults with serious mental illness (SMI) by means of a systematic review and network meta-analysis. Method We searched Embase, Medline, PsychINFO and the Cochrane Central Register of Controlled Trials, from database inception to 1 December 2014 for randomised controlled trials (RCTs) published in English. We included all studies of smokers with SMI (including schizophrenia, schizoaffective disorder, bipolar disorder, delusional disorder and depressive psychoses) who were motivated to quit smoking. Pharmacotherapies included nicotine replacement therapy (NRT), bupropion and varenicline delivered as monotherapy or in combination compared with each other or placebo. The efficacy outcome was self-reported sustained smoking cessation, biochemically verified at the longest reported time point. The tolerability outcome was number of patients discontinuing the trial due to any adverse event Results Seventeen study reports were included which represented fourteen individual RCTs. No trials were found in patients with depressive psychoses, delusional disorder or which compared NRT monotherapy with placebo. A total of 356 and 423 participants were included in the efficacy and tolerability analyses respectively. From the network meta-analysis both bupropion and varenicline were more effective than placebo (OR 4.51 95% Credible Interval (CrI) 1.45 to 14.04 and OR 5.17 95% CrI 1.78 to 15.06 respectively). Data were insensitive to an assessment of varenicline versus bupropion (OR 1.15 95% CrI 0.24 to 5.45). There were no significant differences in tolerability. All outcomes were rated by GRADE criteria as very low quality. Conclusions The limited evidence available to date suggests that bupropion and varenicline are effective and tolerable for smoking cessation in adults with serious mental illnesses.