Program and System Level Interventions to Address Tobacco Amongst Individuals with Schizophrenia

Ziedonis, Douglas M.; Parks, Joe; Zimmermann, Mia Hanos; Csw, Philip McCabe

doi:10.1300/j374v03n03_10

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…The introduction and resourcing of empirically sound health promotion efforts would contribute to shifting tobacco control discourses within the community mental health system. As Ziedonis and colleagues suggest, addressing tobacco use in the context of mental illness requires both program and system level change [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

In the shadow of a new smoke free policy: A discourse analysis of health care providers' engagement in tobacco control in community mental health

Johnson

Moffat

Malchy

2010

Int J Ment Health Syst

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BackgroundThe prevalence of tobacco use among individuals with mental illness remains a serious public health concern. Tobacco control has received little attention in community mental health despite the fact that many individuals with mental illness are heavy smokers and experience undue tobacco-related health consequences.MethodsThis qualitative study used methods of discourse analysis to examine the perceptions of health care providers, both professionals and paraprofessionals, in relation to their roles in tobacco control in the community mental health system. Tobacco control is best conceptualised as a suite of policies and practices directed at supporting smoke free premises, smoking cessation counselling and limiting access to tobacco products. The study took place following the establishment of a new policy that restricted tobacco smoking inside all mental health facilities and on their grounds. Ninety one health care providers participated in open-ended interviews in which they described their role in tobacco control. The interview data were analyzed discursively by asking questions such as: what assumptions underlie what is being said about tobacco?ResultsFive separate yet overlapping discursive frames were identified in which providers described their roles. Managing a smoke free environment emphasised the need to police and monitor the smoke free environment. Tobacco is therapeutic was a discourse that underscored the putative value of smoking for clients. Tobacco use is an individual choice located the decision to smoke with individual clients thereby negating a role in tobacco control for providers. It's someone else's role was a discourse that placed responsibility for tobacco control with others. Finally, the discourse of tobacco control as health promotion located tobacco control in a range of activities that are used to support the health of clients.ConclusionsThis study provides insights into the complex factors that shape tobacco control practices in the mental health field and reinforces the need to see practice change as a matter that extends beyond the individual. The study findings highlight discourses structured by power and powerlessness in environments in which health care providers are both imposing and resisting the smoke free policy.

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Section: Discussionmentioning

confidence: 99%

In the shadow of a new smoke free policy: A discourse analysis of health care providers' engagement in tobacco control in community mental health

Johnson

Moffat

Malchy

2010

Int J Ment Health Syst

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Interventions for smoking cessation and reduction in individuals with schizophrenia

Tsoi

Porwal

Webster

2010

Cochrane Database of Systematic Reviews

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111

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Interventions for smoking cessation and reduction in individuals with schizophrenia

Tsoi

Porwal

Webster

2013

Cochrane Database of Systematic Reviews

182

118

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Bupropion increases smoking abstinence rates in smokers with schizophrenia, without jeopardizing their mental state. Varenicline may also improve smoking cessation rates in schizophrenia, but its possible psychiatric adverse effects cannot be ruled out. CR may help this group of patients to quit and reduce smoking in the short term. We failed to find convincing evidence that other interventions have a beneficial effect on smoking in schizophrenia.

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Program and System Level Interventions to Address Tobacco Amongst Individuals with Schizophrenia

Cited by 4 publications

References 27 publications

In the shadow of a new smoke free policy: A discourse analysis of health care providers' engagement in tobacco control in community mental health

In the shadow of a new smoke free policy: A discourse analysis of health care providers' engagement in tobacco control in community mental health

Interventions for smoking cessation and reduction in individuals with schizophrenia

Interventions for smoking cessation and reduction in individuals with schizophrenia

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