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A randomised controlled trial linking mental health inpatients to community smoking cessation supports: A study protocol

Emily AL Stockings1*, Jennifer A Bowman1, John Wiggers4, Amanda L Baker13, Margarett Terry2, Richard Clancy2, Paula M Wye12, Jenny Knight4 and Lyndell H Moore12

Author Affiliations

1 University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia

2 Mental Health and Substance Use Service (MHSUS), Level 4 McAuley Centre, The Mater Hospital, Edith Street Waratah, NSW, 2298, Australia

3 Centre for Brain and Mental Health Research (CBMHR), Level 5 McAuley Centre, The Mater Hospital, Edith Street Waratah, NSW, 2998, Australia

4 Hunter New England Population Health (HNEPH), Wallsend Health Services, Longworth Avenue Wallsend, NSW, 2287, Australia

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BMC Public Health 2011, 11:570  doi:10.1186/1471-2458-11-570

Published: 17 July 2011

Abstract

Background

Mental health inpatients smoke at higher rates than the general population and are disproportionately affected by tobacco dependence. Despite the advent of smoke free policies within mental health hospitals, limited systems are in place to support a cessation attempt post hospitalisation, and international evidence suggests that most smokers return to pre-admission smoking levels following discharge. This protocol describes a randomised controlled trial that will test the feasibility, acceptability and efficacy of linking inpatient smoking care with ongoing community cessation support for smokers with a mental illness.

Methods/Design

This study will be conducted as a randomised controlled trial. 200 smokers with an acute mental illness will be recruited from a large inpatient mental health facility. Participants will complete a baseline survey and will be randomised to either a multimodal smoking cessation intervention or provided with hospital smoking care only. Randomisation will be stratified by diagnosis (psychotic, non-psychotic). Intervention participants will be provided with a brief motivational interview in the inpatient setting and options of ongoing smoking cessation support post discharge: nicotine replacement therapy (NRT); referral to Quitline; smoking cessation groups; and fortnightly telephone support. Outcome data, including cigarettes smoked per day, quit attempts, and self-reported 7-day point prevalence abstinence (validated by exhaled carbon monoxide), will be collected via blind interview at one week, two months, four months and six months post discharge. Process information will also be collected, including the use of cessation supports and cost of the intervention.

Discussion

This study will provide comprehensive data on the potential of an integrated, multimodal smoking cessation intervention for persons with an acute mental illness, linking inpatient with community cessation support.

Trial Registration

Australian and New Zealand Clinical Trials Registry ANZTCN: ACTRN12609000465257