What prescribers can do to help patients with serious mental illness (SMI) stop smoking
A Public Health Crisis
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Dickerson et al., Cigarette Smoking Among Persons With Schizophrenia or Bipolar Disorder in Routine Clinical Settings, 1999–2011
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Olfson M, Gerhard T, Huang C, Crystal S, Stroup TS. Premature Mortality Among Adults With Schizophrenia in the United States. JAMA Psychiatry. 2015;72(12):1172–1181.
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Cook BL, Wayne GF, Kafali EN, Liu Z, Shu C, Flores M. Trends in Smoking Among Adults With Mental Illness and Association Between Mental Health Treatment and Smoking Cessation. JAMA. 2014;311(2):172–182.
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Williams JM, Stroup TS, Brunette MF, Raney LE. Psychiatr Serv. 2014;65(12):1406-1408.
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Schroeder, S. A. (2016), Smoking cessation should be an integral part of serious mental illness treatment. World Psychiatry, 15: 175–176. doi:10.1002/wps.20332
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Taylor et al. BMJ 2014
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EAGLES?
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Need ref
Smoking cessation treatments work
The results of EAGLES in patients with SMI are consistent with findings from many prior trials in patients with and without mental illness.
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Anthenelli RM, et al., Lancet. 2016
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Anthenelli RM, et al., Lancet. 2016
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Safety of smoking cessation treatments
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Anthenelli RM, et al., Lancet. 2016
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J.R. Hughes. Effects of abstinence from tobacco: valid symptoms and time course. Nicotine Tob. Res. Off. J. Soc. Res. Nicotine Tob., 9 (3) (2007), pp. 315–327
Sustaining smoking cessation
Repeat attempts for persistent smokersAmong patients with prior unsuccessful quit attempts, active smoking cessation treatment was associated with significantly higher quit rates than placebo.
Relapse is common, but continuing medication may help patients stay off cigarettes. Maintenance treatment normalizes the relapse rate for smokers with SMI.
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Evins AE, Cather C, Pratt SA, et al.Maintenance treatment with varenicline for smoking cessation in patients with schizophrenia and bipolar disorder: a randomized clinical trial. JAMA 2014; 311:145–54
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Gonzales, Clin Pharmacol Ther, 2014
References
Notes & DisclaimersThese are general recommendations only; specific clinical decisions should be made by the treating physician based on an individual patient’s clinical condition. The production of this material was supported by a grant from the Patient-Centered Outcomes Research Institute (PCORI). More detailed information is provided at www.tempURLsmokefree.org.