Smoking cessation in severe mental illness: what works?
Abstract
Aims The physical health of people with severe mental illness (SMI) is poor. Smoking-related illnesses are a major contributor to excess mortality and morbidity. An up-to-date review of the evidence for smoking cessation interventions in SMI is needed to inform clinical guidelines. Methods We searched bibliographic databases for relevant studies and independently extracted data. Included studies were randomized controlled trials (RCTs) of smoking cessation or reduction conducted in adult smokers with SMI. Interventions were compared to usual care or placebo. The primary outcome was smoking cessation and secondary outcomes were smoking reduction, change in weight, change in psychiatric symptoms and adverse events. Results We included eight RCTs of pharmacological and/or psychological interventions. Most cessation interventions showed moderate positive results, some reaching statistical significance. One study compared behavioural support and nicotine replacement therapy (NRT) to usual care and showed a risk ratio (RR) of 2.74 (95% CI 1.10-6.81) for short-term smoking cessation, which was not significant at longer follow-up. We pooled five trials that effectively compared bupropion to placebo giving an RR of 2.77 (95% CI 1.48-5.16), which was comparable to Hughes et al.'s 2009 figures for general population data; RR = 1.69 (95% CI 1.53-1.85). Smoking reduction data were too heterogeneous for meta-analysis, but results were generally positive. Trials suggest few adverse events.…
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Data from a systematic review of randomised trials support the notion that cessation improves mental health.
“Data from a systematic review of randomised trials support the notion that cessation improves mental health.Banham and Gilbody systematically reviewed eight trials of smoking cessation interventions in people with severe mental illnesses.37”
From Change in mental health after smoking cessation: systematic review and meta-analysis (2014) · cites this paper as [37]
Banham and Gilbody systematically reviewed eight trials of smoking cessation interventions in people with severe mental illnesses; most showed no difference between active and control groups, but the two studies that reported significant differences favoured the intervention groups.
“Banham and Gilbody systematically reviewed eight trials of smoking cessation interventions in people with severe mental illnesses.37 All trials that assessed psychological function typically used several scales at multiple times.Most showed no difference between active and control groups, but the two studies that reported significant differences favoured the intervention groups.”
From Change in mental health after smoking cessation: systematic review and meta-analysis (2014) · cites this paper as [37]
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- Authors
- Banham, L., & Gilbody, S.
- Affiliations
- South London and Maudsley NHS Foundation Trust (GB)
- University of York (GB)
- Corresponding author
- Banham, Lindsay
- ORCID
- Gilbody, Simon
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2010-06-08
- Volume
- 105
- Issue
- 7
- Pages
- 1176-1189
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W2097564812
- Cited by
- 243
- References
- 10
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 8 · 2020: 12 · 2019: 15 · 2018: 19 · 2017: 16 · 2016: 23 · 2015: 31 · 2014: 30 · 2013: 20 · 2012: 20
- FWCI
- 1.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (07/41/05)
- 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, tobacco dependence, bupropion, nicotine replacement therapy, smoking reduction, weight change, psychiatric symptoms, pharmacological interventions, psychological intervention, physical health of people with mental illness
- MeSH terms
- Adult, Behavior Therapy, Mental Disorders, Body Weight, Female, Humans, Male, Nicotine, Schizophrenic Psychology, Smoking, Time Factors, Tobacco Use Disorder, Randomized Controlled Trials as Topic, Smoking Cessation, Bupropion, Nicotinic Agonists, Dopamine Uptake Inhibitors, Healthcare Disparities
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