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Stanford University School of Medicine

Stop-smoking program aids recovery of psychiatric patients, study finds

While smoking has been in decline in recent years in this country, one group where it remains endemic is among psychiatric patients, who often die prematurely of tobacco-related disease. Practitioners have long thought that smoking could be a useful tool in therapy, calming patients and helping them cope with stress. They also feared that if psychiatric patients were asked to quit, it could interfere with treatment.

But those assumptions are challenged by a new study led by a Stanford researcher, which shows that quitting smoking may be beneficial for these patients. Judith Prochaska, PhD, MPH, and her colleagues at University of California, San Francisco found that a stop-smoking program in hospitalized psychiatry patients aided their recoveries and reduced the chance that they would be hospitalized again for their psychiatric problems.

“This is a very low-cost, brief intervention that helped patients quit smoking and offers evidence that it may have helped their mental health recovery,” said Prochaska, associate professor of medicine with the Stanford Prevention Research Center.

Michael Fiore, MD, MPH, director of the University of Wisconsin Center for Tobacco Research and Intervention and a leader in national policy for tobacco treatment, said:

This paper by Dr. Prochaska and colleagues provides powerful evidence that evidence-based tobacco dependence treatments can substantially increase quit rates among psychiatric inpatients. We know that psychiatric patients smoke at very high rates and are at tremendous risk from their smoking. Thus, the findings hold promise to make an important, real-world contribution to the health of these patients.

The researchers offered stop-smoking treatment to 224 patients at UCSF’s Langley-Porter Psychiatric Institute, a smoke-free, locked unit for acute care. Half participated in a stop-smoking intervention that included a meeting with a counselor, written and electronic materials and the availability of a 10-week supply of nicotine patches. The other half received usual care – a pamphlet about the hazards of smoking and information on how to quit.

At the end of 18 months, 20 percent of those in the treatment group had quit smoking, compared to just 7.7 percent in the control group. Moreover, what was unexpected and striking is that 44 percent of those in the treatment group were rehospitalized, compared to 56 percent in the control group.

“I think some of the therapeutic contact that addressed tobacco dependence and supported participants with this major health goal may have generalized to feeling better about their mental health condition,” Prochaska said.

The study is published online today in the American Journal of Public Health.

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