Brief interventions for smoking or alcohol moderated by history of mental health condition: a national survey of adults in Great Britain 2020-2023.

Abstract

BACKGROUND Individuals with mental health conditions can experience lower life expectancy, partly due to risk factors, such as smoking and alcohol use. OBJECTIVE To assess potential differences in receiving support for smoking cessation or alcohol reduction in British general practice based on history of a mental health condition. METHODS Self-reported data were collected between October 2020 and June 2023 from the monthly cross-sectional Smoking and Alcohol Toolkit Study. The sample included 23 790 adults who smoked in the past year and/or drank at risky levels (ie, Alcohol Use Disorders Identification Test-Consumption≥5). Outcomes included the receipt of brief interventions, the recommendations provided during brief interventions and quit or cut-down attempts triggered by healthcare professionals. Logistic regression models measured associations between outcomes and lifetime mental health history, without and with adjustment for demographic and behavioural factors. FINDINGS Overall, 36.6% had a history of a mental health condition. About two-thirds of people with a history of a mental health condition and half of those without saw their general practitioner (GP) in the past year. Among those with a history of a mental health condition who saw their GP, 41.2% who smoked in the past year received smoking brief interventions and 7.0% who drank at risky levels received alcohol brief interventions. Receipt of smoking brief interventions was similar by history of mental health condition (with 41.2% vs without 41.1%). Individuals with a history of a mental health condition compared with those without had higher odds of receiving alcohol brief interventions (7.0% vs 2.8%, adjusted OR=2.69, 95% CI: 2.17 to 3.34) and receiving more comprehensive support as part of the intervention. DISCUSSION Among respondents with a history of a mental health condition, only around 4 in 10 smokers who visited their GP received brief interventions from their GP and 1 in 20 for alcohol. CLINICAL IMPLICATIONS Considering the links between smoking or risky drinking and mental health conditions, healthcare professionals should increase screening and brief advice to reduce health disparities.