Views about integrating smoking cessation treatment within psychological services for patients with common mental illness: A multi-perspective qualitative study

Gemma M.J. Taylor; Katherine Sawyer; David Kessler; Marcus R. Munafò; Paul Aveyard; Alison Shaw

doi:10.1111/hex.13182

Views about integrating smoking cessation treatment within psychological services for patients with common mental illness: A multi-perspective qualitative study

Gemma M.J. Taylor, Katherine Sawyer, David Kessler, Marcus R. Munafò, Paul Aveyard, Alison Shaw

Research output: Contribution to journal › Article › peer-review

23 Citations (SciVal)

Abstract

BACKGROUND: Tobacco smoking rates are significantly higher in people with common mental illness compared to those without. Smoking cessation treatment could be offered as part of usual outpatient psychological care, but currently is not.

OBJECTIVE: To understand patient and health care professionals' views about integrating smoking cessation treatment into outpatient psychological services for common mental illness.

DESIGN: Qualitative in-depth interviews, with thematic analysis.

PARTICIPANTS: Eleven Improving Access to Psychological Therapies (IAPT) psychological wellbeing practitioners (PWPs), six IAPT patients, and six stop smoking advisors were recruited from English smoking cessation, and IAPT services.

RESULTS: Patients reported psychological benefits from smoking, and also described smoking as a form of self-harm. Stop smoking advisors displayed therapeutic pessimism and stigmatizing attitudes towards helping people with mental illness to quit smoking. PWPs have positive attitudes towards smoking cessation treatment for people with common mental illness. PWPs and patients accept evidence that smoking tobacco may harm mental health, and quitting might benefit mental health. PWPs report expertise in helping people with common mental illness to make behavioural changes in the face of mood disturbances and low motivation. PWPs felt confident in offering smoking cessation treatments to patients, but suggested a caseload reduction may be required to deliver smoking cessation support in IAPT.

CONCLUSIONS: IAPT appears to be a natural environment for smoking cessation treatment. PWPs may need additional training, and a caseload reduction. Integration of smoking cessation treatment into IAPT services should be tested in a pilot and feasibility study.

PATIENT OR PUBLIC CONTRIBUTION: Service users and members of the public were involved in study design and interpretation of data.

Original language	English
Pages (from-to)	411-420
Number of pages	10
Journal	Health Expectations
Volume	24
Issue number	2
Early online date	23 Dec 2020
DOIs	https://doi.org/10.1111/hex.13182
Publication status	Published - 27 Apr 2021

Bibliographical note

Publisher Copyright:
© 2020 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Funding

Dr Gemma Taylor and Ms Katherine Sawyer are funded by Cancer Research UK (Population Researcher Postdoctoral Fellowship award (C56067/A21330). Dr Alison Heawood (nee Shaw) is funded through various NIHR grants. The MRC Integrative Epidemiology Unit at the University of Bristol is supported by the Medical Research Council and the University of Bristol (MC_UU_00011/7). Prof David Kessler is funded by The Centre for Primary Care at the University of Bristol. Prof Paul Aveyard is funded by NIHR, CRUK, Wellcome Trust, BMA Foundation, and MRC, and the NIHR Oxford Biomedical Research Centre and Applied Research Centre. Dr Alison Heawood (nee Shaw) and Prof David Kessler have no conflicts of interest. Dr Gemma Taylor and Prof Marcus Munafò have previously received funding from Pfizer, who manufacture smoking cessation products, for research unrelated to this study. Prof Paul Aveyard led a trial funded by the NIHR and GlaxoSmithKline donated nicotine patches to the NHS in support of the trial. We would like to thank all participants and services that took part in this research. We would like to gratefully acknowledge CRUK for funding this research.

Funders	Funder number
BMA Foundation
NIHR Oxford Biomedical Research Centre and Applied Research Centre
Pfizer
GlaxoSmithKline
The Wellcome Trust
Medical Research Council
National Institute for Health Research
Cancer Research UK	C56067/A21330
University of Bristol	MC_UU_00011/7

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

IAPT
anxiety
depression
improving access to psychological therapies
primary health care
smoking cessation
tobacco smoking treatment

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

Access to Document

10.1111/hex.13182Licence: CC BY

Cite this

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title = "Views about integrating smoking cessation treatment within psychological services for patients with common mental illness: A multi-perspective qualitative study",

abstract = "BACKGROUND: Tobacco smoking rates are significantly higher in people with common mental illness compared to those without. Smoking cessation treatment could be offered as part of usual outpatient psychological care, but currently is not.OBJECTIVE: To understand patient and health care professionals' views about integrating smoking cessation treatment into outpatient psychological services for common mental illness.DESIGN: Qualitative in-depth interviews, with thematic analysis.PARTICIPANTS: Eleven Improving Access to Psychological Therapies (IAPT) psychological wellbeing practitioners (PWPs), six IAPT patients, and six stop smoking advisors were recruited from English smoking cessation, and IAPT services.RESULTS: Patients reported psychological benefits from smoking, and also described smoking as a form of self-harm. Stop smoking advisors displayed therapeutic pessimism and stigmatizing attitudes towards helping people with mental illness to quit smoking. PWPs have positive attitudes towards smoking cessation treatment for people with common mental illness. PWPs and patients accept evidence that smoking tobacco may harm mental health, and quitting might benefit mental health. PWPs report expertise in helping people with common mental illness to make behavioural changes in the face of mood disturbances and low motivation. PWPs felt confident in offering smoking cessation treatments to patients, but suggested a caseload reduction may be required to deliver smoking cessation support in IAPT.CONCLUSIONS: IAPT appears to be a natural environment for smoking cessation treatment. PWPs may need additional training, and a caseload reduction. Integration of smoking cessation treatment into IAPT services should be tested in a pilot and feasibility study.PATIENT OR PUBLIC CONTRIBUTION: Service users and members of the public were involved in study design and interpretation of data.",

keywords = "IAPT, anxiety, depression, improving access to psychological therapies, primary health care, smoking cessation, tobacco smoking treatment",

author = "Taylor, \{Gemma M.J.\} and Katherine Sawyer and David Kessler and Munaf{\`o}, \{Marcus R.\} and Paul Aveyard and Alison Shaw",

note = "Publisher Copyright: {\textcopyright} 2020 The Authors. Health Expectations published by John Wiley \& Sons Ltd.",

year = "2021",

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day = "27",

doi = "10.1111/hex.13182",

language = "English",

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T2 - A multi-perspective qualitative study

AU - Taylor, Gemma M.J.

AU - Sawyer, Katherine

AU - Kessler, David

AU - Munafò, Marcus R.

AU - Aveyard, Paul

AU - Shaw, Alison

PY - 2021/4/27

Y1 - 2021/4/27

N2 - BACKGROUND: Tobacco smoking rates are significantly higher in people with common mental illness compared to those without. Smoking cessation treatment could be offered as part of usual outpatient psychological care, but currently is not.OBJECTIVE: To understand patient and health care professionals' views about integrating smoking cessation treatment into outpatient psychological services for common mental illness.DESIGN: Qualitative in-depth interviews, with thematic analysis.PARTICIPANTS: Eleven Improving Access to Psychological Therapies (IAPT) psychological wellbeing practitioners (PWPs), six IAPT patients, and six stop smoking advisors were recruited from English smoking cessation, and IAPT services.RESULTS: Patients reported psychological benefits from smoking, and also described smoking as a form of self-harm. Stop smoking advisors displayed therapeutic pessimism and stigmatizing attitudes towards helping people with mental illness to quit smoking. PWPs have positive attitudes towards smoking cessation treatment for people with common mental illness. PWPs and patients accept evidence that smoking tobacco may harm mental health, and quitting might benefit mental health. PWPs report expertise in helping people with common mental illness to make behavioural changes in the face of mood disturbances and low motivation. PWPs felt confident in offering smoking cessation treatments to patients, but suggested a caseload reduction may be required to deliver smoking cessation support in IAPT.CONCLUSIONS: IAPT appears to be a natural environment for smoking cessation treatment. PWPs may need additional training, and a caseload reduction. Integration of smoking cessation treatment into IAPT services should be tested in a pilot and feasibility study.PATIENT OR PUBLIC CONTRIBUTION: Service users and members of the public were involved in study design and interpretation of data.

AB - BACKGROUND: Tobacco smoking rates are significantly higher in people with common mental illness compared to those without. Smoking cessation treatment could be offered as part of usual outpatient psychological care, but currently is not.OBJECTIVE: To understand patient and health care professionals' views about integrating smoking cessation treatment into outpatient psychological services for common mental illness.DESIGN: Qualitative in-depth interviews, with thematic analysis.PARTICIPANTS: Eleven Improving Access to Psychological Therapies (IAPT) psychological wellbeing practitioners (PWPs), six IAPT patients, and six stop smoking advisors were recruited from English smoking cessation, and IAPT services.RESULTS: Patients reported psychological benefits from smoking, and also described smoking as a form of self-harm. Stop smoking advisors displayed therapeutic pessimism and stigmatizing attitudes towards helping people with mental illness to quit smoking. PWPs have positive attitudes towards smoking cessation treatment for people with common mental illness. PWPs and patients accept evidence that smoking tobacco may harm mental health, and quitting might benefit mental health. PWPs report expertise in helping people with common mental illness to make behavioural changes in the face of mood disturbances and low motivation. PWPs felt confident in offering smoking cessation treatments to patients, but suggested a caseload reduction may be required to deliver smoking cessation support in IAPT.CONCLUSIONS: IAPT appears to be a natural environment for smoking cessation treatment. PWPs may need additional training, and a caseload reduction. Integration of smoking cessation treatment into IAPT services should be tested in a pilot and feasibility study.PATIENT OR PUBLIC CONTRIBUTION: Service users and members of the public were involved in study design and interpretation of data.

KW - IAPT

KW - anxiety

KW - depression

KW - improving access to psychological therapies

KW - primary health care

KW - smoking cessation

KW - tobacco smoking treatment

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JF - Health Expectations

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ER -

Views about integrating smoking cessation treatment within psychological services for patients with common mental illness: A multi-perspective qualitative study

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Dataset for ‘Views about integrated smoking cessation and IAPT treatment’

Cite this

Views about integrating smoking cessation treatment within psychological services for patients with common mental illness: A multi-perspective qualitative study

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Datasets

Dataset for ‘Views about integrated smoking cessation and IAPT treatment’

Cite this