title: Factors affecting smoking cessation efforts of people with severe mental illness: a qualitative study.
abstract: OBJECTIVE
  People with severe mental illness are much more likely to smoke than are members of the general population. Smoking cessation interventions that combine counseling and medication have been shown to be moderately effective, but quit rates remain low and little is known about the experiences of people with severe mental illness in smoking cessation interventions. To address this gap in knowledge, we conducted a qualitative study to investigate factors that help or hinder the smoking cessation efforts of people with severe mental illness.
  
  
  METHODS
  We recruited 16 people with severe mental illness who had participated in a clinical trial of two different smoking cessation interventions, one involving nicotine replacement therapy only and the other nicotine replacement therapy combined with motivational interviewing and a peer support group. We conducted open-ended, semi-structured interviews with participants, who ranged in age from 20 to 56 years old, were equally distributed by gender (eight men and eight women), and were predominantly Caucasian (n = 13, 81%). Primary mental illness diagnoses included schizophrenia/schizoaffective disorder (n = 6, 38%), depression (n = 5, 31%), bipolar disorder (n = 4, 25%), and anxiety disorder (n = 1, 6%). At entry into the clinical trial, participants smoked an average of 22.6 cigarettes per day (SD = 13.0).
  
  
  RESULTS
  RESULTS indicated that people with mental illness have a diverse range of experiences in the same smoking cessation intervention. Smoking cessation experiences were influenced by factors related to the intervention itself (such as presence of smoking cessation aids, group supports, and emphasis on individual choice and needs), as well as individual factors (such as mental health, physical health, and substance use), and social-environmental factors (such as difficult life events and social relationships).
  
  
  CONCLUSIONS
  An improved understanding of the smoking cessation experiences of people with severe mental illness can inform the delivery of future smoking cessation interventions for this population. The results of this study suggest the importance of smoking cessation interventions that offer a variety of treatment options, incorporating choice and flexibility, so as to be responsive to the evolving needs and preferences of individual clients.
authors.affiliation: a School of Psychology , University of Ottawa , Ottawa , Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rae
authors.forename: Donna
authors.initials: D
authors.lastname: Pettey
authors.forename: Tim
authors.initials: T
authors.lastname: Aubry
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Stol
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D062405:Motivational Interviewing; D016540:Smoking Cessation / Q000523:psychology*; D012944:Social Support; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control*; D055815:Young Adult
keywords: qualitative inquiry; severe mental illness; smoking cessation