Effectiveness of personalized tobacco cessation intervention package among patients with schizophrenia and related psychotic disorders - A two-group experimental study

Asian J Psychiatr. 2023 Mar:81:103447. doi: 10.1016/j.ajp.2023.103447. Epub 2023 Jan 6.

Abstract

Introduction: Persons with schizophrenia and related psychotic disorders (PwS) smoke more, and have twice the rate of mortality, with 10-25 years lower life expectancy than the general population. Evidence-based tobacco cessation interventions would help in quitting.

Aim: To evaluate the effectiveness of a personalized tobacco cessation intervention package for patients attending the outpatient psychiatry department.

Methods: The study adopted a two-group experimental design in PwS, using a simple randomization method. Eligible participants were randomly allocated to either the intervention group (n = 85) receiving the intervention package or the control group (n = 85) receiving brief advice to stop tobacco. The study outcomes were measured at baseline, 1, 3, and 6 months. SPSS 23 was used for data analysis. Intention-to-treat analysis was used to manage missing data. The p-value of < 0.05 is considered statistically significant.

Results: At 6 months, there was a significant difference (p < 0.001) in 7 days point-prevalence abstinence (28 % vs 10.8 %), reduction of tobacco by at least 50 % (62.4 % vs 40.9 %) with an attrition rate of 15.3 % vs 30.5 % in intervention and control group respectively. Reduction in nicotine dependence and tobacco craving, an increase in motivation level, quit attempts and clinical improvement favored the intervention group. 16.5 % of participants expressed interest in pharmacotherapy for tobacco cessation, 3.5 % were referred to a specialized tobacco cessation center, two control group participants were hospitalized for drug default, and withdrawal symptoms reported were mild.

Conclusion: Implementing a tobacco cessation intervention based on the stage of motivation aids in abstinence and reduction of tobacco use in PwS.

Keywords: 50% Reduction; Abstinence; Motivation; Psychosocial intervention; Psychotic disorders; Schizophrenia.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Humans
  • Psychotic Disorders*
  • Schizophrenia*
  • Smoking Cessation*
  • Tobacco Use Cessation* / methods
  • Tobacco Use Disorder*