title: A cross-sectional survey of mental health clinicians' knowledge, attitudes, and practice relating to tobacco dependence among young people with mental disorders.
abstract: BACKGROUND
  Mental health services in England are smoke-free by law and expected to provide comprehensive support to patients who smoke. Although clinicians' knowledge in this area is reported to be limited, research exploring the issue in Child and Adolescent Mental Health Services (CAMHS) is lacking. This study aimed to investigate the knowledge, attitudes, and practice of clinicians working within specialist and highly specialist Child and Adolescent Mental Health Services (CAMHS) relating to tobacco dependence, its treatment and its relation to mental disorder.
  
  
  METHODS
  A cross-sectional survey of clinicians working across all CAMHS teams of a large UK National Health Service mental health Trust.
  
  
  RESULTS
  Sixty clinicians (50% response rate) completed the survey. Less than half (48.3%) believed that addressing smoking was part of their responsibility, and half (50%) asserted confidence in supporting patients in a cessation attempt. Misconceptions relating to smoking were present across all staff groups: e.g. only 40% of respondents were aware of potential interactions between smoking and antipsychotic medications, although psychiatrists were more knowledgeable than non-medical clinicians (91.6% vs 27.1%; OR 3.4, p < .001). Self-reported attendance at smoking-related training was significantly associated with more proactive clinical practice.
  
  
  CONCLUSIONS
  There is a need to improve clinicians' knowledge, capacity and confidence in effectively identifying, motivating, supporting and treating young smokers in the context of treatment for mental disorders.
authors.forename: Meghana
authors.initials: M
authors.lastname: Kulkarni
authors.forename: Lisa
authors.initials: L
authors.lastname: Huddlestone
authors.forename: Anne
authors.initials: A
authors.lastname: Taylor
authors.forename: Kapil
authors.initials: K
authors.lastname: Sayal
authors.forename: Elena
authors.initials: E
authors.lastname: Ratschen
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D009042:Motivation; D065886:Neurodevelopmental Disorders; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000523:psychology