I’ve blogged before about mental health and smoking cessation, so I was interested to read about this new review on the subject published by a researcher in Spain, which aims to assess the best way for adults with major depression, schizophrenia and psychosis to give up smoking.
The review searched a very wide range of databases to retrieve systematic reviews, comprehensive reports, clinical trials, observational studies and recommendations, which had evaluated smoking cessation programs in patients with severe mental illness. Few studies were found and those that were included showed great heterogeneity in the recommendations given.
Nevertheless, the review did make some recommendations for helping people with mental health problems quit smoking:
- Increase and prolong the treatment period
- Implement joint psychoeducation techniques and cognitive-behavioral techniques
- Implement the use of any drug treatment that helps to control and / or reduce the occurrence of relapses in tobacco consumption or baseline psychiatric symptoms
Although the strength of the evidence is relatively weak, with wide confidence intervals, especially for the long-term benefits, the studies support the efficacy of bupropion in smoking cessation and the reduction of the smoking habit in patients with such incapacitating mental diseases such as schizophrenia. For smoking cessation with other therapeutic options such as nicotine replacement therapy and psychosocial interventions, sufficient and robust tests have not been found in this review to support their use in the clinical practice.
Molina-Linde JM. Effectiveness of smoking cessation programs for seriously mentally ill (PDF). [Article in English, Spanish] Actas Esp Psiquiatr. 2011 Mar-Apr;39(2):106-14. Epub 2011 Mar 1.
I can’t help feelings of Orwellian sinister creepings reading this which seems pretty unfair; I know smoking is a bad thing – and a problem for others in a residential or hospital setting – and of course it will likely be consent-driven helping patients to help themselves?
Another point is – I wish systematic literature review in relation to every (major?) disorder treated were built-in fundamentals of the health system – it makes intuitive sense to those outside – or as patients – to anthropoorhise the body of clinicians and the system and to think that this system with all it’s technological (IT especially) intellectual and institutional might – that is ‘the daddy and mummy of medical knowledge’ – would be soaking up and processing all relevant information to assume the best available scientific and medical and human opinion and then strive to execute this understanding in action through all limbs- just like an uber-cyborg en loco parentis should!?