Tobacco Prevention and Cessation (Apr 2023)
Tobacco in Outpatient Mental Health Services: identification of unmet needs
Abstract
Introduction People with mental health disorders have a disproportionately higher prevalence of tobacco consumption compared to the general population, resulting in an increased mortality caused by tobacco-related disorders. However, tobacco has usually been a neglected, non-priority topic in mental health services. Our aim was to describe tobacco control policies and strategies implemented so far in outpatient mental health services in Catalonia and identify unmet needs. Material and Methods Cross-sectional study conducted in 2022. An electronic questionnaire was sent to all the heads of outpatient mental health services in Catalonia (n=203). The questionnaire included 28 items covering four dimensions: intervention; staff training and commitment; control of smoke-free spaces; and tobacco policy communication. While data collection is still in progress, up to the present date 74.4% of responses have been obtained (n=151). Results Staff training and commitment dimensions showed that 67.8% of service heads promoted tobacco control policies, 77.6% supported tobacco cessation interventions and 71.5% claimed that their staff knew how to assist smokers to quit. However, only 48.6% of services included tobacco cessation in their healthcare portfolio, 65.5% registered tobacco consumption systematically in their records, and 54.2% offered help to quit smoking in their care plans. These percentages were lower in child and adolescent centers, where only 26.8% of these centres included tobacco cessation in their healthcare plans, 34.1% offered help to their young patients to quit smoking, and 28.2% provided interventions to prevent tobacco consumption initiation. Conclusions Interventions to systematically identify smokers and offer them effective help to quit are still far from being consistently implemented and are not aligned with mental health care plans. While specific effective interventions are available, a considerable gap remains in facing tobacco use among this population. Efforts and resources need to be directed especially towards the younger population with mental disorders, which is currently receiving even less support than adults.
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