Aims: Smoking represents one of the leading causes of premature early mortality in people with a serious mental illness (SMI). Healthcare services are key contact points for this priority population and can play a critical role in supporting smoking cessation. However, mental health services have not traditionally prioritised smoking cessation support. Queensland public mental health services (PMHS), through a Mental Health Clinical Collaborative (MHCC), have been working together to prioritise smoking, offer standard and routine smoking cessation care to consumers and support access to an intensive Queensland Quitline smoking cessation program. The following provides an overview of the outcomes from this initiative.
Methods: Since 2015 all adult acute and community Queensland PMHS have asked consumers about smoking and provided an evidence-based smoking cessation intervention to smokers (Smoking Cessation Clinical Pathway: SCCP) as part of standard clinical practice across hospital and community services. Queensland PMHS have also partnered with Queensland Quitline to develop a referral pathway to improve access to an evidence-based intensive quit support program providing four support calls and 12 weeks of free NRT for consumer of PMHS. Review of outcomes from this initiative including sustainment of improvement and impact on smoking rates is considered.
Results: Review of outcomes from this initiative have demonstrated positive and continuous improvement. Statewide PMHS have sustained high rates of recording smoking in inpatient 88%-93% (2015-2022) and community services 77%-92% (2017-2020) and in providing the brief intervention SCCP to smokers in inpatient 38%-79% (2015-2020) and community services 47%-85% (2017-2020). Referral and engagement with Quitline has been steady with encouraging retention and quit outcomes. The establishment of a statewide reporting process has also enabled reporting of a Queensland public community mental health smoking rate with the 2021 rate of 50.2% showing a promising decline from 51.6% in 2018.
Conclusions: The sad reality is that people with SMI face enormous challenges to achieving smoking cessation. Healthcare services are in a unique position to provide and connect consumers to smoking cessation support. Queensland PMHS have worked together to embed smoking cessation care into standard practice statewide and proactively assist consumers to access ongoing cessation support through an intensive Quitline program with encouraging results.
