Economic cost of smoking in people with mental disorders in the UK

Wu, Qi; Szatkowski, Lisa; Britton, John; Parrott, Steve

doi:10.1136/tobaccocontrol-2013-051464

Cited by 20 publications

(17 citation statements)

References 7 publications

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“…Smoking prevalence among psychiatric populations varies, with much higher rates among those with severe mental illnesses, such as schizophrenia and psychosis spectrum disorders and bipolar disorder than among the general population [1][2][3]. Despite a steady decline in smoking rates in the general populations of high-income nations, the prevalence of smoking among people with severe mental illness has not reduced over the past several decades [4]. Indeed, approximately 60% of people who experience psychotic illness smoke [1,3,5].…”

Section: Introductionmentioning

confidence: 99%

Targeted Intervention to Reduce Smoking among People with Severe Mental Illness: Implementation of a Smoking Cessation Intervention in an Inpatient Mental Health Setting

et al. 2020

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Background and Objectives: Smoking and smoking-related harms are highly prevalent among people with severe mental illness. Targeted smoking cessation programs are much needed in this population. This pilot study aimed to assess the effectiveness of implementing smoking cessation system change interventions within an acute inpatient mental health unit. Materials and Methods: Design: Pre-post intervention study. System change interventions for smoking cessation were delivered over a three-month period (05 March 2018–04 June 2018) on an acute inpatient mental health unit. Participants (n = 214) were all individuals receiving care as inpatients during the three-month intervention. Outcomes assessed pre- and post-intervention were: (i) recording of patient smoking status in medical notes, (ii) number of inpatients offered smoking cessation medication, and iii) number of violent incidents reported. Results: Recording of smoking status significantly increased from 1.9% to 11.4% (X2 = 14.80; p ≤ 0.001). The proportion of inpatients offered smoking cessation treatment significantly increased from 11.0% to 26.8% (X2 = 16.01; p ≤ 0.001). The number of violent incidents decreased by half, which was not statistically significant. Conclusion: Evidence-based smoking cessation interventions can be successfully implemented on an inpatient mental health unit. Modest gains were made in routine screening for smoking and in smoking cessation treatment prescription. Future studies should prioritize effective participatory collaboration with staff to optimize effectiveness of interventions and should include additional strategies such as brief intervention training and smoking cessation treatments such as varenicline and buproprion in addition to nicotine replacement therapy (NRT).

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Section: Introductionmentioning

confidence: 99%

Targeted Intervention to Reduce Smoking among People with Severe Mental Illness: Implementation of a Smoking Cessation Intervention in an Inpatient Mental Health Setting

et al. 2020

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“…The economic costs of smoking are high among low-SES and disadvantaged groups. Most recent estimates using the WHO’s Economics of Tobacco Toolkit indicate that the economic cost of smoking for people with mental illness in the UK was £2.34 billion from 2009 to 2010 [ 20 ]. This high cost and burden of disease attributable to tobacco smoking has led to calls for the “ development and implementation of smoking cessation interventions ” to be a “ high economic and clinical priority ” among low-SES and disadvantaged population groups, particularly smokers with mental disorders [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Smoking Cessation among Low-Socioeconomic Status and Disadvantaged Population Groups: A Systematic Review of Research Output

Courtney

Naicker

Shakeshaft

et al. 2015

IJERPH

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Background: Smoking cessation research output should move beyond descriptive research of the health problem to testing interventions that can provide causal data and effective evidence-based solutions. This review examined the number and type of published smoking cessation studies conducted in low-socioeconomic status (low-SES) and disadvantaged population groups. Methods: A systematic database search was conducted for two time periods: 2000–2004 (TP1) and 2008–2012 (TP2). Publications that examined smoking cessation in a low-SES or disadvantaged population were coded by: population of interest; study type (reviews, non-data based publications, data-based publications (descriptive, measurement and intervention research)); and country. Intervention studies were coded in accordance with the Cochrane Effective Practice and Organisation of Care data collection checklist and use of biochemical verification of self-reported abstinence was assessed. Results: 278 citations were included. Research output (i.e., all study types) had increased from TP1 27% to TP2 73% (χ² = 73.13, p < 0.001), however, the proportion of data-based research had not significantly increased from TP1 and TP2: descriptive (TP1 = 23% vs. TP2 = 33%) or intervention (TP1 = 77% vs. TP2 = 67%). The proportion of intervention studies adopting biochemical verification of self-reported abstinence had significantly decreased from TP1 to TP2 with an increased reliance on self-reported abstinence (TP1 = 12% vs. TP2 = 36%). Conclusions: The current research output is not ideal or optimal to decrease smoking rates. Research institutions, scholars and funding organisations should take heed to review findings when developing future research and policy.

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“…Surveys in the UK and the US have consistently found negative associations between having mental health problems and having quit smoking [5,14,15], although this association is attenuated when taking heaviness of smoking into account [5]. Increased smoking cessation among smokers with mental health problems would reduce significant avoidable costs to the economy, consisting of direct medical costs, lost productivity and premature mortality [16]. Thus, there is an urgent need to improve cessation in this group as emphasised by a cross-government outcomes strategy [17], the National Institute for Health and Care Excellence (NICE, [18]) and a Lancet Psychiatry Commission [4].…”

Section: Introductionmentioning

confidence: 99%

Mental health and smoking cessation—a population survey in England

Brose

Brown

McNeill

2020

BMC Med

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Background: To reduce inequalities between individuals with and without mental health problems, a better understanding is required of triggers and success of quit attempts among the third of smokers with mental health problems. The aim was to assess whether there are differences by mental health status in (i) triggers for quit attempts, (ii) use of evidence-based support (iii) and quit success. Methods: Monthly cross-sectional household surveys of representative samples of the adult population in England. In 2016/2017, 40,831 adults were surveyed; 1956 who had attempted to stop smoking cigarettes in the past year were included. Logistic regressions assessed associations between mental health (ever diagnosis, past-year treatment, past-month distress), triggers, support used and quit success, adjusting for sociodemographic and smoking characteristics. Results: Concern about future health, current health problems and expense of smoking were the most common triggers overall. For respondents with an ever diagnosis, past-year treatment or serious past-month distress, quit attempts were more frequently triggered by current health problems. Non-evidence-based support and e-cigarettes were used most often, and this did not differ by mental health status. Respondents with an ever diagnosis and moderate or serious distress were less likely to have used non-prescription nicotine replacement therapy (NRT). Respondents with past-year treatment or serious distress were more likely to have used prescription medication/ behavioural support. Quit success did not differ by mental health status. Compared with non-evidence-based support, non-prescription NRT conferred no benefit. There was some evidence that prescription medication/ behavioural support was beneficial (depending on outcome and adjustment, ORs ranged from 1.46, 95% CI 0.92-2.31, to 1.69, 1.01-2.86). E-cigarettes were associated with higher success rates after adjustment for different indicators of mental health (ORs ranged from 2.21, 1.64-2.98, to 2.25, 1.59-3.18). Conclusions: Smokers with mental health problems were more likely to have attempted to quit because of health problems and were more likely to have used gold standard support (medication and behavioural support) than other smokers. E-cigarettes were strongly associated with increased success and were used similarly by those with and without mental health problems, indicating that improved uptake of e-cigarettes for smoking cessation among smokers with mental health problems could help address inequalities.

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Economic cost of smoking in people with mental disorders in the UK

Abstract: Background and AimsSmoking is the largest preventable cause of death in the UK

Cited by 20 publications

References 7 publications

Targeted Intervention to Reduce Smoking among People with Severe Mental Illness: Implementation of a Smoking Cessation Intervention in an Inpatient Mental Health Setting

Targeted Intervention to Reduce Smoking among People with Severe Mental Illness: Implementation of a Smoking Cessation Intervention in an Inpatient Mental Health Setting

Smoking Cessation among Low-Socioeconomic Status and Disadvantaged Population Groups: A Systematic Review of Research Output

Mental health and smoking cessation—a population survey in England

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