Making the journey with me: a qualitative study of experiences of a bespoke mental health smoking cessation intervention for service users with serious mental illness.
Smoking is one of the major modifiable risk factors contributing to early mortality for people with serious mental illness. However, only a minority of service users access smoking cessation interventions and there are concerns about the appropriateness of generic stop-smoking services for this group. The SCIMITAR (Smoking Cessation Intervention for Severe Mental Ill-Health Trial) feasibility study explored the effectiveness of a bespoke smoking cessation intervention delivered by mental health workers. This paper reports on the nested qualitative study within the trial.



Qualitative semi-structured interviews were conducted with 13 service users receiving the intervention and 3 of the MHSCPs (mental health smoking cessation practitioners) delivering the intervention. Topic guides explored the perceived acceptability of the intervention particularly in contrast to generic stop-smoking services, and perceptions of the implementation of the intervention in practice. Transcripts were analysed using the Constant Comparative Method.



Generic services were reported to be inappropriate for this group, due to concerns over stigma and a lack of support from health professionals. The bespoke intervention was perceived positively, with both practitioners and service users emphasising the benefits of flexibility and personalisation in delivery. The mental health background of the practitioners was considered valuable not only due to their increased understanding of the service users' illness but also due to the more collaborative relationship style they employed. Challenges involved delays in liaising with general practitioners and patient struggles with organisation and motivation, however the MHSCP was considered to be well placed to address these problems.



The bespoke smoking cessation intervention was acceptable to service users and the both service users and practitioners reported the value of a protected mental health worker role for delivering smoking cessation to this group. The results have wider implications for understanding how to achieve integrated and personalised care for this high-risk population and further underscore the need for sensitised smoking cessation support for people with serious mental illness.



Current Controlled Trials ISRCTN79497236 . Registered 3(rd) July 2009.
NIHR School for Primary Care Research and Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK. sarah.knowles@manchester.ac.uk.
Sarah
S
Knowles
NIHR School for Primary Care Research and Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK.
Claire
C
Planner
School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, M13 9PL, UK.
Tim
T
Bradshaw
Department of Health Sciences, University of York, York, YO10 5DD, UK.
Emily
E
Peckham
School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK.
Mei-See
MS
Man
Department of Health Sciences, University of York, York, YO10 5DD, UK.
Simon
S
Gilbody
D000328:Adult; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011613:Psychotherapy / Q000379:methods*; D036301:Qualitative Research; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology