The NHS has been challenged to examine the support it gives to people with mental ill health who want to give up smoking.
The challenge is made in a new report, Smoking and Mental Health, by the NHS Confederation’s Mental Health Network. The report presents a picture of the disproportionate impact smoking has on mental health services and service users:
• One third of people with mental ill health smoke regularly, compared with one fifth among the general population
• Up to 70% of patients in mental health units smoke, with 50% described as heavy smokers
• Smoking adds up to £40 million to the UK's psychotropic drug costs, due to the impact of smoking on metabolisation of many psychiatric drugs.
The report, published 2 weeks before the start of the annual 'Stoptober' smoking cessation campaign, calls on mental health providers to examine the work they are doing to help service users quit smoking. It incorporates a list of ‘key questions’ for boards to consider and challenges the wider NHS to play its part.
Smoking and mental health also examines the evidence about how best to reduce smoking among mental health service users. It finds that many want to stop smoking and can with tailored interventions and enhanced support.
Stephen Dalton, chief executive of the Mental Health Network, said: "The effect of smoking on physical health is well known but we would be remiss if we ignore its impact on mental health. People with serious mental illness die up to 25 years earlier than their mentally healthy counterparts. If we are genuine about putting mental health on a par with physical health, we need to face up to the fact that smoking is responsible for a significant amount of the excess mortality of people with severe mental health problems.
"No-one is suggesting that boards ride roughshod over the needs and preferences of patients, but we're currently in danger of sending a message to some of those at highest risk of being damaged by cigarettes that it's OK to smoke. It's a curious situation that you can't smoke in the pub but you can in hospital.
"I'm not pretending it's not difficult, but there is nothing about enabling unwell and vulnerable people to smoke that is in their best interests. What our report addresses is what can and has been achieved and what more can be and should be done.
"We know people with mental health conditions can take longer to engage with stop smoking services, or require higher levels of support, but we must consider the whole person, not just their mental health in isolation. Helping service users to quit smoking is about delivering on public health priorities and securing long-term health benefits.''