EPA guidance on tobacco dependence and strategies for smoking cessation in people with mental illness.
Tobacco dependence is the most common substance use disorder in adults with mental illness. The prevalence rates for tobacco dependence are two to four times higher in these patients than in the general population. Smoking has a strong, negative influence on the life expectancy and quality of life of mental health patients, and remains the leading preventable cause of death in this group. Despite these statistics, in some countries smokers with mental illness are disadvantaged in receiving intervention and support for their tobacco dependence, which is often overlooked or even tolerated. This statement from the European Psychiatric Association (EPA) systematically reviews the current evidence on tobacco dependence and withdrawal in patients with mental illness and their treatment. It provides seven recommendations for the core components of diagnostics and treatment in this patient group. These recommendations concern: (1) the recording process, (2) the timing of the intervention, (3) counselling specificities, (4) proposed treatments, (5) frequency of contact after stopping, (6) follow-up visits and (7) relapse prevention. They aim to help clinicians improve the care, health and well-being of patients suffering from mental illness.
Department of Psychiatry, Ludwig Maximilian University, Nussbaumstrasse 7, 80336 Munich, Germany. Electronic address: tobias.ruether@med.uni-muenchen.de.
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T
Rüther
Department of Medicine, Psychiatry Area, University of Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, Cibersam, Oviedo, Asturias, Spain.
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J
Bobes
University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Department Neuroscience KU Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium.
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M
De Hert
Department of Physiology and Pharmacology, Section of Neuropsychopharmacology, Karolinska Institute, Stockholm, Sweden.
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TH
Svensson
Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
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K
Mann
Department of Psychiatry and Psychotherapy, Section for Addiction Medicine and Research, University Hospital of Tübingen, Tübingen, Germany.
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A
Batra
Sainte-Anne Hospital (CMME), University Paris-Descartes, Paris, France.
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P
Gorwood
Department of Psychiatry, Ludwig Maximilian University, Nussbaumstrasse 7, 80336 Munich, Germany.
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HJ
Möller
D006801:Humans; D001523:Mental Disorders / Q000150:complications* / Q000523:psychology; D008603:Mental Health; D028642:Persons with Psychiatric Disorders; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*
Affective disorders; Mental disorders; Schizophrenia; Smoking; Tobacco dependence; Tobacco use cessation