Smoking cessation for people with severe mental ill health (SCIMITAR): results from a pilot randomised controlled trial

S Gilbody, Emily Peckham, Mei-See Man, Natasha Mitchell, Jinshuo Li, Taeko Becque, Catherine Hewitt, Sarah Knowles, Timothy Bradshaw, Claire Planner, Steve Parrott, Susan Michie, Charles Shepherd

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    Background People with severe mental ill health (SMI) are three times more likely to smoke; contributing to widening health inequalities and reduced life expectancy. We therefore aimed to investigate the feasibility of a new intervention targeted at smokers with SMI and the methods of recruitment, randomisation, and follow up for a full trial. Methods We designed a bespoke smoking cessation package that could be delivered by mental health nurses. This consisted of behavioural support and medication. In a pilot RCT, 97 participants with bipolar illness and schizophrenia were randomly allocated to usual care (n=51) or usual care plus bespoke smoking cessation (n=46). Participants were recruited from NHS primary care and mental health settings in York/Scarborough, Hull and Manchester. Simple randomisation was used with computer generated random numbers. It was not possible to blind participants, GPs, and researchers to the treatment allocation. Our primary outcome was carbon monoxide verified smoking status at 12 months. The trial was registered (ISRCTN79497236). Findings There was good engagement with a bespoke smoking cessation intervention, but no usual care participants accessed NHS smoking cessation services. For 68 participants for whom we had data at 12 months (35 usual care and 33 intervention), the rate of smoking cessation was higher amongst those who received a bespoke smoking cessation intervention (36% versus 23%) but did not reach statistical significance (adjusted odds ratio 2•9, 99% confidence interval 0•8, 10•5). Interpretation We recruited and randomised people with SMI to a bespoke smoking cessation intervention, and the level of engagement with quit smoking strategies was higher than in a usual care control group. The effectiveness and safety of specially-designed smoking cessation programme for people with SMI should now be tested in a fully-powered RCT. Funding This study was funded by NIHR Health Technology Assessment Programme.
    Original languageEnglish
    JournalThe Lancet Psychiatry
    Issue number5
    Publication statusPublished - 1 Apr 2015


    • Smoking cessation
    • Serious mental illness


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