Multiple Perspectives on Tobacco Use among Youth with Mental Health Disorders and Addictions

Morris, Chad; May, Mandy G.; Devine, Karen; Smith, Shawn; DeHay, Tamara; Mahalik, John L.

doi:10.4278/ajhp.100610-qual-179

Cited by 11 publications

(15 citation statements)

References 43 publications

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“…Specifically, it points to variability in provider practice around cessation for pregnant and postpartum women, which is consistent with previous findings [22,23]. A cultural shift in practice is thus necessary to eliminate mixed messaging, and encourage open channels of communication about smoking between women and their providers.…”

Section: Discussionsupporting

confidence: 83%

“…It further explores geographical and socio-cultural factors related to cessation and how barriers and challenges to provision and access to services can be addressed through a more comprehensive approach. While the provision of cessation programs and services for priority populations is mandated by the Ontario Public Health Standards a , there is an apparent lack of cessation support for pregnant and postpartum women across Ontario’s 36 Public Health Units [23]. While this paper focuses upon improving Ontario’s cessation system to better meets the needs of pregnant and postpartum women who smoke, a forthcoming paper explores socio-ecological barriers, as illuminated by women in this study.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the adequacy of smoking cessation support for pregnant and postpartum women

et al. 2013

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BackgroundSmoking in pregnancy exemplifies the relationship between tobacco use and health inequalities. While difficulty reaching and engaging this population in cessation support is often highlighted in the literature, there is limited research that explores the factors that shape the provision and use of support by this subpopulation. Using Ontario, Canada, as a case study, this study examines how the use of cessation support by women is encouraged or discouraged by cessation policy, programming and practice; how geographical and sociocultural factors influence provision and uptake of support; and how barriers and challenges can be addressed through a comprehensive approach.MethodsSemi-structured, in-depth interviews with key informants (31) and pregnant or postpartum women (29) were conducted to examine the cessation needs of this subpopulation, barriers to the provision and uptake of cessation support and directions for policy, service provision and programming.ResultsKey barriers included: the absence of a provincial cessation strategy and funding, capacity and engagement/accessibility issues. Geographical features presented additional challenges to provision/uptake, as did the absence of resources tailored to Aboriginal women and adolescents. Key informants recommended a comprehensive cessation strategy to facilitate coordination of cessation resources provincially and locally and elucidated the need for capacity building within tobacco control and within reproductive, child and maternal health. Participants also highlighted the need to further develop tobacco control policies and target the social determinants of health through poverty reduction, housing and education support. The provision of incentives, transportation, childcare and meals/snacks; adoption of woman-centred, harm-reduction and stigma reduction approaches; and promotion of programs through a variety of local venues were recommended by participants to address engagement and accessibility issues.ConclusionsThe current cessation system in Ontario is not equipped to adequately reduce smoking among pregnant and postpartum women. A comprehensive, multi-sector strategy designed to provide tailored and sustainable support through different system entry points is needed. A cultural shift in practice is also necessary to eliminate mixed messaging, strengthen practice and encourage open channels of communication about smoking between women and their providers. The study highlights the need to address smoking among women in a more holistic manner and for capacity building strategies that focus on strengthening providers’ competency and confidence in practice. Future research should explore: capacity building strategies, especially among rural and remote communities; the smoking and cessation experiences of different subpopulations of pregnant and postpartum women; the effectiveness of tailored strategies; and interventions that address smoking among partners and other family members.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Exploring the adequacy of smoking cessation support for pregnant and postpartum women

et al. 2013

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“…; Morris et al . ). These opinions contrast with the opinions of MHS staff who describe service users as unable to become smoke‐free, the process of supporting and promoting being smoke‐free as not relating to their roles, and that tobacco harm is the least of service users' worries (Dickens et al .…”

Section: Resultsmentioning

confidence: 97%

“…Participant 6 stated: 'just because you have a mental illness doesn't mean you can't be helped and actually go smoke-free'. This is supported by recent published work focusing on service user experiences of smoke-free MHS (Keizer et al 2010;McFall et al 2006;Morris et al 2011). These opinions contrast with the opinions of MHS staff who describe service users as unable to become smoke-free, the process of supporting and promoting being smokefree as not relating to their roles, and that tobacco harm is the least of service users' worries (Dickens et al 2004;Nash & Romanos 2010;Sarna et al 2009).…”

Section: Mental Health Is Differentmentioning

confidence: 95%

Qualitative exploration of family perspectives of smoke‐free mental health and addiction services

Missen¹,

Brannelly

Newton‐Howes

2012

Int J Mental Health Nurs

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The significant health disparities experienced by people with mental illness indicate the need for mental health service improvement. This qualitative study explored family and whānau (Māori family group) perspectives of smoke-free mental health services. Thematic analysis found that family and whānau identified a number of barriers to the implementation of successful smoke-free policy, including lack of coordination and consistency, and limited, if any, family and whānau inclusion. Family and whānau discussed smoking as a strategy for coping with anxiety and boredom; therefore, the need for other activities and strategies to replace smoking was identified as necessary in effective service delivery. The attitude that mental health service policy should be different from general health policy, due to the experience of mental distress, was also identified. In this paper, we argue that the development and implementation of quality mental health services would be strengthened by involving family and whānau in smoke-free initiatives. Furthermore, the provision of relevant information to family, whānau, and service users would help dispel myths and stigma associated with tobacco and mental health.

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“…no use of nicotine replacement therapy, other medicines, or counseling). Adolescent tobacco cessation attempts are rarely planned, and adolescents tend to choose unassisted quit methods rather than seeking out cessation aids (Morris et al, 2011); however, young people who enroll in a tobacco cessation program are twice as likely to succeed in their quit attempt than those who attempt to quit unaided (Fiore et al, 2008).…”

Section: Motivation To Quitmentioning

confidence: 97%

Tobacco use in youth with mental illnesses

et al. 2011

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Despite an abundance of literature documenting the prevalence and dangers of youth tobacco use, there is a relative dearth of literature in the area of effective cessation treatments for youth (Fiore et al. in Clinical tobacco guideline: treating tobacco use and dependence, 2008). Additionally, although it has been widely accepted that mental illness is highly correlated with tobacco use and dependence, little research has been done to support prevention and cessation efforts for youth with mental illnesses. This paper summarizes the literature on tobacco use and cessation in youth, with a focus on describing the existing knowledge base for youth with mental illnesses.

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Multiple Perspectives on Tobacco Use among Youth with Mental Health Disorders and Addictions

Cited by 11 publications

References 43 publications

Exploring the adequacy of smoking cessation support for pregnant and postpartum women

Exploring the adequacy of smoking cessation support for pregnant and postpartum women

Qualitative exploration of family perspectives of smoke‐free mental health and addiction services

Tobacco use in youth with mental illnesses

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