Fellowship - Acceptability and feasibility of delivering a bespoke smoking cessation treatment in community mental health settings for people with depression

This abstract has been reviewed by people who smoke and have depression and anxiety.

Tobacco use is the world's leading preventable cause of cancer. In the UK and other developed nations smoking prevalence has significantly declined in the general population. However, smoking prevalence has remained unchanged in those with mental health problems resulting in an excess burden of premature death and mortality from smoking-related cancers. People with depression and anxiety are twice as likely to smoke as people without depression and anxiety but they are much less likely to receive help to quit compared to smokers without mental health problems. Thus to continue tackling smoking-related cancers this population needs to be urgently targeted with interventions that are tailored to meet the needs of this group. A major barrier to tackling smoking in this population is the widespread belief amongst smokers and many health professionals that smoking offers mental health benefits, and that stopping smoking will worsen mental health. However, recent studies led by myself have shown that smoking cessation likely improves depression and anxiety.

Aims: During this fellowship, I will work in collaboration with people who have lived-experience of depression and smoking to co-design a bespoke smoking cessation intervention and examine its feasibility in community mental health settings.

Methods: This project involves two work-streams, all to be conducted collaboratively with stakeholders and people with relevant lived-experience. First, we will co-design a small multi-centre intervention study and run the intervention in community mental health settings. The feasibility of the programme and trial processes will be measured by assessing recruitment, retention, adherence to treatment and therapist fidelity. We will also check the feasibility of linking participants' electronic medical records to examine cancer outcomes overtime for use in a full randomised controlled trial (RCT) in the future. In the second work-stream, participants and clinicians will be interviewed to determine their acceptability and experiences of the intervention. Results from these work-streams will inform a protocol for a full-sized RCT, written in collaboration with stakeholders.

Dissemination: Results from this research will be co-analysed, peer-reviewed and co-authored by researchers with lived experience of depression and smoking. The findings of this research will be submitted to peer-reviewed journals and presented at conferences. Results and study progress will be presented to collaborators and the NHS Trusts involved, and will inform a protocol for a full-sized multi-centre RCT, submitted for a project grant by the end of the fellowship.

WHO registered pilot and feasibility randomised controlled trial: ISRCTN99531779.