Turning of the tide: changing systems to address smoking for people with a mental illness

Abstract

Smoking tobacco is common among people with a mental illness. A number of behavioural and environmental factors underlie the high smoking prevalence rates. Evidence suggests that smokers with mental illness require additional targeted support to help them stop smoking. By using a selective review of the international literature, this article will argue that a systems-level change approach is an appropriate strategy, targeting settings and environments with a number of advantages for reaching smokers with mental illness. Systems-level changes include: (1) implementing a system of identifying and recording smoking status;(2) providing education, resources and feedback to promote staff intervention;(3) dedicating staff to provide tobacco-dependence treatment;(4) promoting organisational policies that support and provide tobacco-dependence services. Three settings will be discussed – mental health services, community social service organisations and prisons. As a result of a history and culture where smoking ...