Those with severe mental health problems die – on average – 25 years earlier than the rest of the population. Smoking-related illnesses are one of the major causes of early mortality and poor physical health in this disenfranchised group. Additionally, those with enduring mental health problems give much of their limited income back to the state in taxes on the tobacco they buy. Successful interventions to help quit smoking would address this scandalous health inequality and also help reduce tobacco poverty.
There also exists a general therapeutic nihilism about what can be done to help people with enduring mental health problems to quit smoking or reduce their dependence upon tobacco. Perhaps this reflects a more deeply entrenched historical culture of smoking in mental health services (amongst staff and service users).
This talk will outline the detrimental health impact of smoking in severe mental health and will present the results of recent systematic review of ‘what works’ for this group. Professor Simon Gilbody heads the Mental Health Services Research Group at the University of York, and is soon to begin a trial of bespoke smoking cessation interventions funded by the NIHR Health Technology Assessment Programme. This will be the largest UK trial to address smoking amongst those with enduring mental health problems, and will help us judge whether this therapeutic nihilism is justified.