Two heads are better than one: Australian tobacco control experts’ and mental health change champions’ consensus on addressing the problem of high smoking rates among people with mental illness

Rowley, Della; Lawn, Sharon; Coveney, John

doi:10.1071/ah15028

Cited by 6 publications

(5 citation statements)

References 38 publications

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“…However, this exercise represents the first stage of a comprehensive project that will involve at later stages a focus group study to get WP smokers’ opinions about the 13 final HWLs and ways to improve them. Also, where prior information is lacking for the most part, the Delphi method is recommended to facilitate knowledge synthesis,18 19 through a structured, systematic communication technique 46…”

Section: Discussionmentioning

confidence: 99%

“…Consensus methods among experts such as the Delphi method can facilitate knowledge synthesis 18 19. Delphi is a structured, systematic communication technique that involves a multistage process, with each stage building on the results of the previous one to achieve consensus among experts 46.…”

Section: Stage 2: Conducting a Modified Delphi Studymentioning

confidence: 99%

“…In this study we describe the process and outcomes from using a modified Delphi approach to develop a set of potential WP-specific HWLs 18 19. Our approach involved two stages: (1) developing 28 WP-specific HWLs corresponding to five main themes from the literature including health risks, addiction, harm to others, WP-specific harm and WP harm compared with cigarettes; and (2) conducting a Delphi study among an international WP expert panel to select the top ranked HWLs for potential effectiveness and further testing.…”

Section: Introductionmentioning

confidence: 99%

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Delphi study among international expert panel to develop waterpipe-specific health warning labels

et al. 2019

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BackgroundWaterpipe (WP) smoking is increasing globally. The rise of WP has been fuelled by widespread misperception of reduced-harm compared to cigarettes. Health warning labels (HWLs) are one strategy to communicate smoking-related risks and address reduced-harm misperceptions. Therefore, the development of WP-specific HWLs represents a priority for WP control.MethodsA panel of experts in WP science developed 28 WP-specific HWLs corresponding to five themes (health risks, addiction, harm to others, WP-specific harm, WP harm compared to cigarettes). Subsequently, a three-round Delphi study was conducted among international expert panel to reach consensus on a set of the most effective HWLs for each theme. Levels of agreement between participants were assessed using interquartile deviations, and the rank between the tied HWLs was based on the median.ResultsStarting with 28 candidate HWLs stratified according to five WP-related themes, our international expert panel reached consensus on the 13 most important WP-specific HWLs. Labels with the highest agreement were related to oral and heart disease, WP’s harmful effects on newborn children and the amount of smoke inhaled from WP compared to cigarettes.ConclusionThis study is the first to systematically develop and evaluate potential WP-specific HWLs based on the scientific evidence about WP’s harmful effects, scientific understanding of HWL for cigarettes and the opinions of experts in WP science, tobacco control and health communication. The final selected HWLs can be adapted based on the context and policy landscape of the target country and can be further fine-tuned based on feedback from WP smokers and non-smokers.

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Section: Discussionmentioning

confidence: 99%

Section: Stage 2: Conducting a Modified Delphi Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Delphi study among international expert panel to develop waterpipe-specific health warning labels

et al. 2019

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“…y-QUIT incorporated all elements recommended as necessary to reduce the very high rates of smoking amongst this population, namely training in brief interventions, motivational interviewing, and pharmacological support (41). That delivery of all interventions was by a mental health nurse with additional tobacco cessation training demonstrates that this model is immediately translatable to community mental health settings where there is sufficient funding and support from clinicians and managers to do so.…”

Section: Discussionmentioning

confidence: 99%

y-QUIT: Smoking Prevalence, Engagement, and Effectiveness of an Individualized Smoking Cessation Intervention in Youth With Severe Mental Illness

et al. 2018

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Introduction: Young people with psychosis are six times more likely to be tobacco smokers than their gender- and age-matched peers. Smoking is a major contributor to the 15-year reduced life expectancy among people experiencing severe mental illness (SMI). There is a lack of evidence-supported interventions for smoking cessation among young people with SMI.Material and Methods: The study comprised two phases and aimed to assess (i) the prevalence of smoking among a community sample of young people with psychotic illness or at high risk of developing psychosis; (ii) the proportion who engaged in the intervention; (iii) the proportion who achieved smoking cessation; and (iv) secondary smoking-related outcomes. In phase one, prevalence of smoking was assessed among young people with psychotic illness or at high risk of developing psychosis attending a community-based youth mental health service between 16/5/2017 and 16/11/2017. In phase two, over a 1-year period, individuals identified as smokers were invited to participate in a 12-week tailored smoking cessation intervention program that included pharmacological treatment, motivational interviewing, and behavioral change techniques. Those unwilling to participate in a full intervention were offered a brief intervention. Participants of the full intervention were assessed at baseline and at week 12 endpoint on: daily cigarettes smoked (self-report), exhaled CO, nicotine dependence, readiness to quit, and confidence to quit.Results: In phase one, smoking prevalence was 48.2% (53 of 110) among clients of the youth mental health service. Smokers were significantly more likely to be male (X2 = 6.41 p = 0.009). During phase two, 41 of 61 eligible clients engaged in a smoking cessation intervention (67.2%). Effectiveness: twenty-one clients participated in a full intervention (34.4%), of whom three (14.3%) received a brief intervention initially and during engagement converted to full intervention. Twenty participants (32.8%) received a brief intervention only. Ten participants in the full intervention (47.6%) and five in the brief intervention (25%) dropped out. Six (28.6% of full intervention) reported smoking cessation verified by CO monitoring. Participants who completed the full intervention (n = 9) reduced number of cigarettes smoked, nicotine dependence, and exhaled CO, while readiness to quit and confidence to quit increased. Pharmacotherapy was predominantly combination NRT (n = 18; 85.7%), varenicline (4.8%), oral NRT only (4.8%), or none (4.8%). No adverse events were reported.Conclusion: This pilot real-world study demonstrates that both screening for smoking and offering an effective smoking cessation intervention are achievable in youth experiencing or at risk of psychosis.

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“…Several factors may account for this difference in smoking prevalence. Adults with mental health issues report self-medicating with tobacco to manage psychological distress (Rowley, Lawn, & Coveney, 2015), as well as a greater feeling of reward from nicotine intake (Allan, 2013) College London; date: 19 September 2017 2010), and higher rates of relapse after attempting to quit than the general smoking population (Lukowski, Morris, Young, & Tinkelman, 2015). This may contribute to lower quit success rates and therefore higher overall prevalence.…”

Section: Mental Health and Personal Predisposition Mental Healthmentioning

confidence: 99%

Psychological Aspects of Tobacco Control

McGowan¹,

Shahab²

2017

Oxford Research Encyclopedia of Psychology

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Worldwide, tobacco use is a leading cause of morbidity and mortality. However, the health effects of smoking are reversible, making smoking cessation an important target for public health policy. Tobacco control is a field of public health science dedicated to reducing tobacco use and, thereby, to reducing cigarette-related morbidity and mortality. For tobacco control to be effective, it is necessary for policy makers to understand the personal and interpersonal factors which encourage people to smoke, factors which motivate smokers to quit (e.g., health, social pressure, cost), and the personal and population-level methods that are most effective at encouraging and prolonging attempts to quit. Research has identified that social norms, mental health, and individual personality factors are most associated with smoking uptake, so interventions which reduce social smoking (e.g., smoking bans, plain packaging) would be most effective at preventing uptake. Conversely, the use of cigarettes is maintained by nicotine addiction and attempts to quit are often motivated by health concerns, social pressure and the cost of tobacco products. As such, interventions that address physiological and behavioral addiction inherent in tobacco product use (e.g., nicotine replacement therapy combined with counselling), that create social pressure to stop (e.g., mass media campaigns), or that increase the cost of tobacco products are most likely to be effective at encouraging attempts to quit.

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Two heads are better than one: Australian tobacco control experts’ and mental health change champions’ consensus on addressing the problem of high smoking rates among people with mental illness

Cited by 6 publications

References 38 publications

Delphi study among international expert panel to develop waterpipe-specific health warning labels

Delphi study among international expert panel to develop waterpipe-specific health warning labels

y-QUIT: Smoking Prevalence, Engagement, and Effectiveness of an Individualized Smoking Cessation Intervention in Youth With Severe Mental Illness

Psychological Aspects of Tobacco Control

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