Counseling of Patients with Severe Psychiatric Conditions and Referral to Smoking Cessations Programs

Background: Cigarette smoking and Nicotine dependence are highly prevalent in patients with severe and chronic mental illness. Psychiatric patients consume more cigarettes than general population. Smokers with chronic mental illness can quit smoking with appropriate intervention by smoking cessations programs. These patients can benefit from pharmacotherapy, but consideration should be given for possible interaction with patients’ psychiatric medications. Tobacco use and dependence need to be formally documents on electronic medical records and be offered a referral to smoking cessations programs.

Method: All patients in a community rehabilitation service ward in Northwest London were interviewed to identify the type, quantity, and duration of their tobacco. Their electronic clinical records were reviewed to confirm their age, ICD 10 Primary Diagnosis, ICD10 Tobacco dependence diagnosis, medications they take, record of ECG tests and presence of cardiopulmonary problems. Then their records were checked if they were given advice regarding their smoking habit, desire to quit smoking and agreement to be referred to a smoking cessation program.

Results and Discussion: Half of the total number of patients in the community psychiatric rehabilitation were cigarette smokers. Majority of the smokers had history of polysubstance abuse. Recording of current smoking status were not regularly update. Patients who had recorded status of being a smoker were all referred to a smoking cessation program and majority had counseling by the healthcare professionals in their unit. Attending the smoking cessation program in those patients have as good outcomes as general population.

Conclusions: A substantial number of patients in psychiatric rehabilitation units smoke cigarettes. If their smoking status is accurately documented, they would be referred to a formal smoking cessation program.