A University of York professor has called for urgent international action to tackle what he describes as an "unseen epidemic" of tobacco-related deaths among people with mental ill health.
The new intervention is already being rolled out across the NHS
Writing in the New England Journal of Medicine, Professor Simon Gilbody and colleagues highlight the disproportionate impact of smoking on people with mental health conditions such as depression, schizophrenia and bipolar disorder.
They are around three times more likely to smoke than the general population, reducing life expectancy by 15–20 years largely due to tobacco-related diseases. The team points to evidence from the SCIMITAR+ trial, the largest study of its kind, that tested a bespoke smoking cessation programme for people with mental ill health.
Participants received tailored support from trained mental health professionals, including enhanced levels of contact. It was designed in partnership with people who use mental health services, and helped people to quit safely and effectively, without any disruption in their mental health, providing a clear blueprint for health systems.
New training
The new intervention is already being rolled out across the NHS and forms the basis of new training materials from the National Centre for Smoking Cessation and Training.
Professor Gilbody, from the University of York's Department of Health Sciences and Hull York Medical School, said: "The SCIMITAR+ findings show that tailored support works. Health systems should provide interventions responsive to the needs of people using mental health services. The tools to save lives are already here, and it is now urgent that we start using them."
The York team is now scaling this work internationally through the SCIMITAR-South Asia programme in Pakistan, India and Bangladesh, funded by the National Institute for Health and Care Research (NIHR). Co-authors Dr Garima Bhatt from York and Dr Krishna Muliyala from India's National Institute of Mental Health and Neurosciences say the initiative will help adapt these strategies to local health systems.
Evidence based
Professor Gilbody said: "What we need is evidence-solutions and our latest trials show what those solutions are and just how quickly they can work. These aren't expensive solutions either. In fact they save money by preventing the harms that tobacco causes and they can be delivered by mental health professionals with the right training.
"It is important to recognise that there is not one solution that fits all, and health practitioners are best placed to know exactly how to tailor smoking interventions to the needs of their patient."
