Empowering psychiatric services to deal with tobacco control

I want to quit

Göran Boëthius MD, PhDTobacco Control UnitÖstersund HospitalSwedenChair Doctors Against Tobacco

13th International Conference on Health Promoting HospitalsDublin May 19, 2005

Smoking rates by mental health disorders (HDA 2004)

• Often heavy smokers• Makes them very sick• Social welfare says ”quit first”• Many want to quit• It´s almost impossible to quit

without adequate support • It´s almost impossible to get

adequate support

Smoking among the mentally ill

• It´s important to support psychiatric patients in smoking cessation

• There are effective treatments

• The treatment should be adjusted to the psychiatric patient´s special needs

Smoking cessation

• Plan the cessation process

• Strong nicotine dependence

• The disease in itself can prolong and complicate the process

• Intensive support over a long time

The Quitting Process I

• Nicotine replacement therapy (NRT) effective

• Bupropion (Zyban) - great care

• Depression - risk of new episode

• Monitor blood levels of neuroleptics

The Quitting Process II

• All psychiatric units should be smoke-free

• Provide NRT generously

• All professionals should be trained

Policy recommendations for psychiatric care

It´s cynical to treat the psychiatric disorder and leave the patient to die from smoking

For more information

Barbro Holm Ivarsson, Psychologists against Tobacco

barbro.holm-ivarsson@fhi.se

Göran Boëthius, Doctors Against Tobacco

goran.boethius@jll.se

Katarina Törnqvist, Nurses Against Tobacco

katarina.tornqvist@sll.se

Carina Altsjö, Pharmacy Against Tobacco

carina.altsjo@apoteket.se