title: Evaluating the efficacy of an integrated smoking cessation intervention for mental health patients: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Smoking rates, and associated negative health outcomes, are disproportionately high among people with mental illness compared to the general population. Smoke-free policies within mental health hospitals can positively impact on patients' motivation and self-efficacy to address their smoking. However, without post-discharge support, preadmission smoking behaviours typically resume. This protocol describes a randomised controlled trial that aims to assess the efficacy of linking mental health inpatients to community-based smoking cessation supports upon discharge as a means of reducing smoking prevalence.
  
  
  METHODS
  Eight hundred participants with acute mental illness will be recruited into the randomised controlled trial whilst inpatients at one of four psychiatric inpatient facilities in the state of New South Wales, Australia. After completing a baseline interview, participants will be randomly allocated to receive either: 'Supported Care', a multimodal smoking cessation intervention; or 'Normal Care', consisting of existing hospital care only. The 'Supported Care' intervention will consist of a brief motivational interview and a package of self-help material for abstaining from smoking whilst in hospital, and, following discharge, 16 weeks of motivational telephone-based counselling, 12 weeks of free nicotine replacement therapy, and a referral to the Quitline. Data will be collected at 1, 6 and 12 months post-discharge via computer-assisted telephone interview. The primary outcomes are abstinence from smoking (7-day point prevalence and prolonged cessation), and secondary outcomes comprise daily cigarette consumption, nicotine dependence, quit attempts, and readiness to change smoking behaviour.
  
  
  CONCLUSIONS
  If shown to be effective, the study will provide evidence in support of systemic changes in the provision of smoking cessation care to patients following discharge from psychiatric inpatient facilities.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ANZTCN: ACTRN12612001042831. Date registered: 28 September 2012.
authors.affiliation: University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. alexandra.metse@uon.edu.au.
authors.forename: Alexandra P
authors.initials: AP
authors.lastname: Metse
authors.forename: Jenny A
authors.initials: JA
authors.lastname: Bowman
authors.forename: Paula
authors.initials: P
authors.lastname: Wye
authors.forename: Emily
authors.initials: E
authors.lastname: Stockings
authors.forename: Maree
authors.initials: M
authors.lastname: Adams
authors.forename: Richard
authors.initials: R
authors.lastname: Clancy
authors.forename: Margarett
authors.initials: M
authors.lastname: Terry
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfenden
authors.forename: Megan
authors.initials: M
authors.lastname: Freund
authors.forename: John
authors.initials: J
authors.lastname: Allan
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Prochaska
authors.forename: John
authors.initials: J
authors.lastname: Wiggers
mesh_terms: D002985:Clinical Protocols; D003376:Counseling; D019033:Delivery of Health Care, Integrated; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007297:Inpatients; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008603:Mental Health; D062405:Motivational Interviewing; D009517:New South Wales; D010351:Patient Discharge; D010353:Patient Education as Topic; D012008:Recurrence; D012107:Research Design; D012907:Smoking / Q000009:adverse effects / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology; D000074606:Smoking Prevention; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome