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Cited by 30Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesChronic Obstructive Pulmonary Disease (COPD) Research

A systematic review of behavioural smoking cessation interventions for people with severe mental ill health—what works?

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Spanakis, Panagiotis, Peckham, Emily, Young, Ben, Heron, Paul, Bailey, Della, Gilbody, Simon·2022·Addiction
DOI 10.1111/add.15724PMC PMC9298065
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Abstract

BACKGROUND AND AIMS: People with severe mental ill health smoke more and suffer greater smoking-related morbidity and mortality. Little is known about the effectiveness of behavioural interventions for smoking cessation in this group. This review evaluated randomized controlled trial evidence to measure the effectiveness of behavioural smoking cessation interventions (both digital and non-digital) in people with severe mental ill health. DESIGN: Systematic review and random-effects meta-analysis. We searched between inception and January 2020 in Medline, EMBASE, PsycINFO, CINAHL, Health Management Information Consortium and CENTRAL databases. SETTING AND PARTICIPANTS: Randomized controlled trials (RCTs) assessing the effects of behavioural smoking cessation and reduction interventions in adults with severe mental ill health, conducted in any country, in either in-patient or community settings and published in English. MEASUREMENTS: The primary outcome was biochemically verified smoking cessation. Smoking reduction and changes in mental health symptoms and body mass index (BMI) were included as secondary outcomes. Narrative data synthesis and meta-analysis were conducted and the quality of included studies was appraised using the risk of bias 2 (RoB2) tool. FINDINGS: We included 12 individual studies (16 articles) involving 1861 participants. The first meta-analysis (three studies, 921 participants) demonstrated effectiveness of bespoke face-to-face interventions compared with usual care across all time-points [medium-term: relative risk (RR) = 2.29, 95% confidence interval (CI) = 1.38-3.81; long-term: RR = 1.58, 95% CI = 1.09-2.30]. The second (three studies, 275 participants) did not demonstrate any difference in effectiveness of bespoke digital on-line interventions compared with standard digital on-line interventions (medium-term: RR = 0.87, 95% CI = 0.17-4.46). A narrative overview revealed mixed results when comparing bespoke face-to-face interventions with other active interventions. The methodological quality of studies was mixed, with the majority having some concerns mainly around risk of selective reporting. CONCLUSIONS: Face-to-face bespoke smoking cessation interventions for adults with severe mental ill health appear to be effective when compared with treatment as usual, but evidence is equivocal when compared with other active interventions. There is limited evidence comparing bespoke digital interventions with generic interventions, and we found no studies comparing them with usual treatment.

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  • Meta-analysis of community-based smoking cessation studies showed that individually tailored face-to-face interventions are superior to standard care for smoking cessation, but comparing bespoke digital on-line interventions vs standard digital on-line interventions did not demonstrate any difference in effectiveness.

    “Meta-analysis of these studies showed that individually tailored face-to face interventions are superior to standard care for smoking cessation, but comparing bespoke digital on-line interventions vs. standard digital on-line interventions did not demonstrate any difference in effectiveness (88).”

    From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [88]

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Research works printed but not linked: 1

  1. [36]Williams JM, Steinberg ML, Zimmermann MH, Gandhi KK, Stipelman B, Budsock PD, et al. Comparison of two intensities of tobacco dependence counseling in schizophrenia and schizoaffective disorder. J Subst Abuse Treat. 2010; 38: 384– 93. 20363089 PMC2859987

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Authors
Spanakis, P., Peckham, E., Young, B., Heron, P., Bailey, D., & Gilbody, S.
Affiliations
  • University of York (GB)
  • University of Glasgow (GB)
Corresponding author
Spanakis, Panagiotis
ORCID
Venue
Addiction
Publisher
Wiley
Published
2021-11-06
Volume
117
Issue
6
Pages
1526-1542
ISSN
  • 0965-2140 (ISSN-L)
  • 1360-0443
DOI
10.1111/add.15724
PMC
PMC9298065
OpenAlex
W3209884850
Cited by
30
References
42
Citations by year
2026: 8 · 2025: 11 · 2024: 5 · 2023: 4 · 2021: 2
FWCI
0.37
Type
journal article
Language
en
Open access
Licence
Locations
  • Addiction (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
Funders
  • Department of Health, Australian Government
  • National Institute for Health Research
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Keywords
smoking cessation, severe mental illness, behavioral interventions, digital interventions, face-to-face intervention, smoking reduction, body mass index, psychiatric symptoms, treatment effectiveness
MeSH terms
Adult, Behavior Therapy, Mental Disorders, Humans, Mental Health, Smoking, Randomized Controlled Trials as Topic, Smoking Cessation

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