What carers of family members with mental illness say, think and do about their relative's smoking and the implications for health promotion and service delivery: a qualitative study

Smoking Cessation Care for People with a Mental Illness: Family Carer Expectations of Health and Community Services

“…Family carer support for total smoking bans is comparable to the level of support reported by mental health inpatient staff (54%) and inpatients (46%) in previous Australian research Wye et al, 2010); and consistent with carers previously identifying the appropriate opportunity to support smoking cessation amongst people with a mental illness that smoke-free policies within mental health services represent (Lawn et al, 2015;Missen et al, 2013). The sizeable proportion of participants that were 'unsure' of the benefits of smoking bans may have been influenced by a lack of knowledge or awareness of smoking bans and their implementation, as has been found in research conducted amongst mental health professionals (Lawn & Campion, 2013;Lawn, 2004;Wye et al, 2010).…”

“…The high prevalence of participant expectation that smoking cessation care should be provided across all of the settings investigated aligns with previous research conducted with family carers which identified an expectation that the smoking behaviours of the person with a mental illness should be addressed in mental and general health services they attended (Lawn et al, 2015;Missen et al, 2013). Similarly, previous studies of support by clinical staff for the provision of smoking cessation care in inpatient and community mental health services (Robson, Haddad, Gray, & Gournay, 2013;Wye et al, 2010b), GPs (Holmberg et al, 2014), and NGOs (Bryant et al, 2012).…”

“…It may also be, as described in Lawn et al (2015), that cohabiting carers perceived the supply, distribution, and regulation of tobacco to the person they cared for as a part of their caring role despite the knowledge of the physical health risks associated with smoking. Carers may perceive a greater importance in monitoring a consistent tobacco consumption or encouraging a decrease in consumption as opposed to encouraging cessation (Lawn et al, 2015). Further research is required to gain a better understanding of this association.…”

“…Finally, the survey explored carers' perceptions of the effects of smoking on the mental health of the person they cared for but did not explore the perceived physical health effects. Further research could explore the extent to which carers perceive a negative physical health effect of smoking; however, the limited research to date does suggest that carers are aware of the negative physical health consequences (Lawn, McNaughton, & Fuller, 2015), as might be expected given the high levels of such awareness within the community generally (Mulshine & Healton, 2014).…”

“…A small qualitative study of six family member perspectives' in New Zealand identified several key limitations in the delivery of smoking cessation care, including a lack of consistency of implementation; family inclusion; and information regarding the harms of tobacco and benefits of available cessation treatments, and impact of cessation on client mental distress (Missen, Brannelly, & Newton-Howes, 2013). In addition, an Australian qualitative study of 12 family carers described that family carers reported suboptimal smoking cessation care from mental health services for smokers with a mental illness for whom they provided care (Lawn, McNaughton, & Fuller, 2015). Given this limited evidence base, an exploratory study was conducted to: 1) Explore family carer: understanding of the relationships between smoking and mental health; views of smoking bans in specialist mental health treatment settings; and expectations of smoking cessation care provision across four types of health and community service settings.…”