Tobacco dependence support during and following an acute mental health inpatient admission: A cross-sectional survey of care provision in England

TL;DR

This study examines how tobacco dependence support is provided during and after mental health hospital stays in England.

Contribution

The study provides a descriptive analysis of tobacco dependence care in NHS mental health wards across England.

Findings

Most Trusts offer behavioral support, nicotine replacement therapy, and e-cigarettes during hospital stays.

Post-discharge tobacco dependence support is less consistently provided across Trusts.

All Trusts use healthcare professionals trained in smoking cessation, with some additional mental health-specific training.

Abstract

Although significant efforts have been made to promote smoking cessation, people with mental health conditions continue to be more likely to smoke and to consume more tobacco than those without mental illness. This survey aimed to describe the provision of tobacco dependence support offered during admission and following discharge from NHS acute adult mental health wards across England.

A cross-sectional online descriptive questionnaire survey was conducted between August and September 2024 in National Health Service (NHS) Mental Health Trusts in England. Questions included identifying the Trust and role of the person responding, and characteristics of tobacco dependence support offered to patients when admitted to acute mental health wards and at discharge.

Of the 50 Trusts approached, a response rate of 44% (n=22) was achieved. Almost all of the respondent Trusts reported offering behavioral support (n=22; 100%), nicotine replacement therapy (n=21; 95.45%), and e-cigarettes (n=21; 95.45%) during participants’ time in hospital. Tobacco dependence support offered post-discharge was reported to be in place less frequently (n=13; 59.09%); variations in the duration of support were reported. Tobacco dependence support was delivered by healthcare professionals who had completed National Centre for Smoking Cessation and Training (NCSCT) Practitioner training in all Trusts, with most Trusts also offering the NCSCT specialist Mental Health module training and/or in-house training.

Inpatient tobacco dependence support within NHS mental health settings in England is relatively consistent; however, post-discharge care varies, presenting an opportunity to enhance smoking cessation outcomes.