title: Do people with mental illness receive adequate smoking cessation advice? A systematic review and meta-analysis.
abstract: BACKGROUND
  Prevalence rates of smoking in people with mental illness are high, and premature mortality attributed to tobacco related physical comorbidity is a major concern. We conducted a meta-analysis comparing rates of receipt of smoking cessation advice among people with and without mental illness.
  
  
  METHODS
  Major electronic databases were searched from inception till August 2014 for studies comparing rates of receipt of smoking cessation advice of people with and without a mental illness. Two independent authors completed methodological appraisal and extracted data. A random-effects meta-analysis was utilized.
  
  
  RESULTS
  Seven studies of satisfactory methodological quality (n mental illness=68,811, n control=652,847) were included. Overall there was no significant difference in smoking cessation advice rates between those with and without a mental illness [relative risk (RR)=1.02, 95% confidence interval (CI)=0.94-1.11, n=721,658, Q=1421, P<.001]. Subgroup analyses demonstrated people with severe mental illness (SMI) received comparable rates of smoking cessation advice to those without SMI (RR=1.09, 95% CI=0.98-1.2, n=559,122). This remained true for people with schizophrenia (RR=1.09, 95% CI=0.68-1.70) and bipolar disorder (RR=1.14, 95% CI=0.85-1.5). People with non-SMIs were slightly more likely to receive smoking cessation advice (RR=1.16, 95% CI=1.04-1.30, Q=1364, P<.001, n=580,206).
  
  
  CONCLUSIONS
  People with SMI receive similar smoking cessation advice rates to people without mental illness, while those with non-SMI are slightly more likely to receive smoking cessation advice. While progress has been made, offering smoking cessation advice should receive a higher priority in everyday clinical practice for patients with a mental health diagnosis.
authors.affiliation: Department of Cancer Studies & Molecular Medicine, Leicester Royal Infirmary, Leicester, LE1 5WW, UK. Electronic address: ajm80@le.ac.uk.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Mitchell
authors.affiliation: Department of Neurosciences, KU Leuven-University of Leuven, UPC KU Leuven Campus Kortenberg, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Tervuursevest 101, B-3001 Leuven, Belgium.
authors.forename: Davy
authors.initials: D
authors.lastname: Vancampfort
authors.affiliation: Department of Neurosciences, KU Leuven-University of Leuven, UPC KU Leuven Campus Kortenberg, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: De Hert
authors.affiliation: School of Health and Social Care, University of Greenwich, Southwood Site Avery Hill Road Eltham, London SE9 2UG, UK.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
mesh_terms: D003376:Counseling / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*
keywords: Mental illness; Severe mental illness; Smoking; Smoking cessation; Systematic review