Author(s): Ineke Keizer*, Marianne Gex-Fabry, Patrice Croquette and Aqal Nawaz Khan
Background: Specific approaches for smokers presenting with psychiatric disorders are scarce, even though the prevalence of smoking does not tend to decline in mental health settings, in contrast with general populations of most western countries.
Methods: Inpatient smokers (n=69) in a public mental health hospital participated in a multicomponent motivational intervention based on a temporary 26 h abstinence period. Evaluations, performed 1 week pre-, during and 1 week post-intervention, included cigarette consumption, carbon monoxide level, stage of change, craving, as well as anxiety, depression, well-being and smoking cessation self-efficacy.
Results: Carbon monoxide level significantly decreased during the intervention (median 16 to 6 ppm, p<0.001), with 76.8% of participants using nicotine replacement therapy. Craving decreased (MPSS 5 to 4, p=0.01), together with anxiety (STAI-State 47 to 38, p<0.001) and depression (BDI-21 18 to 13, p<0.001), whereas well-being increased (WHO-5 11 to 16, p<0.001). During the proposed 26 h abstinence period, 45.6% of participants successfully abstained from smoking, of which 58.1% subsequently attempted quitting. Ten participants (14.5% of 69) decided to stop smoking even though they had no intention to quit before the program. Self-efficacy for permanent cessation did not change, but self-efficacy for temporary abstinence increased (median 8 at pre- to 9 at post-evaluation, p=0.003).
Conclusion: A short multicomponent motivational intervention based on temporary abstinence can be a positive experience for patients with severe psychiatric disorders, contribute to increase self-efficacy and trigger quit attempts. The present study suggests that integration of such a program in mental health care is feasible and wellaccepted.
