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People with SMI need more support to stop smoking

People with severe mental illness (SMI) should be given more support to stop smoking to prevent them dying prematurely from smoking related diseases, says the Royal College of Psychiatrists.

In a new position statement the College advises that healthcare professionals should consider prescribing varenicline to people with SMI and advising them that electronic cigarettes (ECs) can be effective in helping some people to quit smoking entirely.

The key messages are:

  • Smoking rates among people with SMI are much higher than in the general population, contributing to increased morbidity and premature mortality among this group.
  • More investment is required in stop smoking services – tailored to meeting the needs of people with SMI – which provide access to a range of effective treatments.
  • People with SMI who want to quit smoking should be prescribed varenicline, a generally safe and well-tolerated medication shown to increase rates of smoking cessation in psychiatric and non-psychiatric populations. 
  • Patients with SMI should be advised that ECs are an effective option for giving up smoking, particularly when used in conjunction with stop smoking treatments, and are substantially safer than continued tobacco use.

PCRS Executive Chair Dr Noel Baxter says: “Health professionals working with people who have respiratory illness know that those who have co-morbid mental health problems do worse than those without and that a large part of the cause is co-existent smoked tobacco dependency. We know that the majority of people with severe mental illness want to quit but they are not receiving support in the same proportions as people without SMI.

“It is time to take tobacco dependency treatment more seriously and provide patients with the NICE and the Royal College of Psychiatrists approved drug and behavioural interventions that we know work and are safe.”

Comprehensive guidance on helping patients, including those with SMI, is available in the draft PCRS

PCRS Produced / Collaboration
Clinical Area: 
Tobacco smoking and nicotine
Listing Status: