EPA Guidance on tobacco dependence and strategies for smoking cessation in people with mental illness

• Published in: European psychiatry Vol. 29; no. 2; pp. 65 - 82
• Main Authors: Rüther, T., Bobes, J., De Hert, M., Svensson, T.H., Mann, K., Batra, A., Gorwood, P., Möller, H.J.
• Format: Journal Article
• Language: English
• Published: Paris Elsevier Masson SAS 01.02.2014; Elsevier
• Subjects: Addictive behaviors; Adult and adolescent clinical studies; Affective disorders; Biological and medical sciences; Desintoxication. Drug withdrawal; General aspects; Humans; Internal Medicine; Medical sciences; Mental disorders; Mental Disorders - complications; Mental Disorders - psychology; Mental Health; Mentally Ill Persons; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Schizophrenia; Smoking; Smoking Cessation - methods; Smoking Cessation - psychology; Tobacco dependence; Tobacco smoking; Tobacco use cessation; Tobacco Use Disorder - complications; Tobacco Use Disorder - psychology; Tobacco Use Disorder - therapy; Tobacco, tobacco smoking; Toxicology; Treatments; Tobacco use cessation; Schizophrenia; Mental disorders; Affective disorders; Tobacco dependence; Smoking; Mood disorder; Poison withdrawal; Tobacco smoking; Psychosis; Affective disorder; Treatment; Mental disorder; Strategy
• ISSN: 0924-9338; 1778-3585; 1778-3585
• DOI: 10.1016/j.eurpsy.2013.11.002

Tobacco dependence is the most common substance use disorder in adults with mental illness. The prevalence rates for tobacco dependence are two to four times higher in these patients than in the general population. Smoking has a strong, negative influence on the life expectancy and quality of life of mental health patients, and remains the leading preventable cause of death in this group. Despite these statistics, in some countries smokers with mental illness are disadvantaged in receiving intervention and support for their tobacco dependence, which is often overlooked or even tolerated. This statement from the European Psychiatric Association (EPA) systematically reviews the current evidence on tobacco dependence and withdrawal in patients with mental illness and their treatment. It provides seven recommendations for the core components of diagnostics and treatment in this patient group. These recommendations concern: (1) the recording process, (2) the timing of the intervention, (3) counselling specificities, (4) proposed treatments, (5) frequency of contact after stopping, (6) follow-up visits and (7) relapse prevention. They aim to help clinicians improve the care, health and well-being of patients suffering from mental illness.