Smoking cessation intervention among people with a psychotic disorder: 4 year followup

  • Professor Robyn Richmond, School of Public Health and Community Medicine, University of New South Wales, Australia
  • Assoc Professor Amanda Baker, Centre for Mental Health Studies, University of Newcastle, Australia
  • Mr Terry Lewin,, University of Newcastle, Australia
  • Dr Frances KayLambkin, National Drug and Alcohol Research Centre, University of New South Wales., Australia

    • Background: People with a psychotic illness much higher rates of smoking than the general population (90% vs 20%). Yet few randomised controlled trials have been conducted among this group.

    Aims: To investigate 4 year outcomes among participants previously enrolled in a randomised controlled trial of an 8 session individually administered smoking cessation intervention for smokers with a psychotic disorder.

    Methods: Of the 247 participants recruited to the NHMRC funded randomised controlled trial in Sydney and Newcastle who had previously completed the 1-year follow up, 149 completed the 4-year follow up.

    Results: At 4-year follow up, 79% of the available sample reported maintenance or improvement in their smoking reduction status relative to 1-year. Abstinence at 1-year, rather than smoking reduction, was significantly associated with point prevalence abstinence at 4-years. Lengthy periods of abstinence were also evident among participants reporting 4-year point prevalence abstinence or at least a 50% reduction. No baseline or intervention status variables predicted smoking status at 4 years. There were improvements in symptoms and function between baseline and 4 years.

    Conclusion: The results indicate that smokers with a psychotic disorder are capable of longterm change in their smoking. Although continuous abstinence is rare, lengthy periods of abstinence are not uncommon, suggesting that longer, more flexible interventions are needed which address the fluctuating course of smoking cessation.