Offering evidence-based support and treatment to your patients with mental health conditions will give them the best chance to quit smoking. Most smokers with a mental health condition want to quit, and with the right supports, can quit successfully.
Routinely offer and provide support to your clients with mental health conditions who smoke by following the three brief intervention steps:
Asking your client at each visit, or during clinical review, reinforces the importance of stopping smoking, boosts motivation and will often trigger a quit attempt. One in 33 conversations about quitting with a health professional will lead to a successful quit attempt. Asking will also help you understand:
- Why they smoke
- Where they are at with their smoking (are they interested in quitting or cutting down)
- Motivations or reasons for quitting
- Their smoking habits and triggers
- What stops them from quitting
If your client is not ready to address their smoking, then advise in a clear, non-confrontational and personalised way:
“Stopping smoking is the single most important thing you can do for your health”
“Stopping smoking can aid your mental health recovery”
“I’m here to help whenever you’re ready to talk about how you can cut down or quit”
For more ideas on how to talk to your clients about their smoking check out this clip from Dr Hayden McRobbie, an international expert on behavioural medicine.
Remind your clients on the best way to quit and stay quit.
- Behavioural support or coaching (such as Quitline, stop smoking services)
- Nicotine replacement therapy (NRT) or stop smoking medications.
“Smoking cessation interventions that combine behavioural support with cessation pharmacotherapy are likely to be effective in people with mental disorders” Smoking and Mental Health: A joint report by the Royal College of Physicians and Royal College of Psychiatrists (2013)
If your client is interested in quitting, depending on your role, you could provide direct support and/or link them to a range of other supports.
Behavioural support or coaching
Discuss with your client what behavioural supports they’d like to use. Options include:
- Quitline (13 7848) is a free and confidential counselling service that can increase a caller’s chance of quitting successfully. They have tailored services for people with mental health conditions and can guide your client through getting ready to quit and quitting. Referring your client online or by fax is easy
- Stop smoking service or Quit Educator: Contact your local health service which may have a smokefree clinic or staff qualified to support smoking cessation.
- General practitioner or psychiatrist: Encourage your client to talk to their GP or psychiatrist about their plans to stop smoking, and quitting medications. They can assist with prescribing NRT products or quitting medications, and monitor their mental health and medication levels during the quitting process.
- Mental Health Service: Your client may also be able to get support through their local mental health service from a mental health practitioner.
Nicotine replacement therapy products or quitting medications
People with mental health conditions generally smoke more cigarettes daily and each cigarette more intensely. Providing nicotine replacement therapy products or quitting medications is important. In Australia, nicotine replacement therapy products and quitting medications available include:
- Transdermal – patches
- Intermittent – lozenges, mouth spray, gum and inhalator
- Bupropion (Zyban®)
- Varenicline (Champix®)
Make an appointment with a GP to assess which products are best for your client and to get a script.
NRT patches, gum or lozenge, and Champix or Zyban, are available at a lower cost on the PBS.
Combination therapy may be recommended if your client has had cravings or not succeeded in quitting when using a single nicotine replacement product. It is usually recommended for heavy smokers.
Clients should talk to their doctor or pharmacist first before using combination therapy.
Remember: People with mental health conditions may be taking medications that will need to be regularly reviewed or dosage adjusted by a doctor when they cut down or quit.
The facts: mental health and smoking
In Australia, smoking rates for people with mental health conditions range from 25 to 50% depending on their diagnosis. One of the reasons that rates continue to remain high is that there are many myths that persist about the links between smoking and mental health. It’s important to know the facts about smoking, mental health and how to quit, so that you or your patients will have the best chance of quitting for good.
How quitting improves mental health
There are a number of benefits for people with mental health conditions once they have quit.
Mental health and smoking: tools and resources
Below are tools and resources related to mental health and smoking. There is also a range of more general resources which can be ordered or downloaded to support health professionals and clients on this site.
How to embed smoking cessation support into your organisation
Embedding smoking cessation supports into everyday care for mental health services takes a whole of organisation/service approach.