Stop smoking this Mental Health Awareness Week

Mary Yates, Nurse Consultant at South London and Maudsley NHS Foundation Trust, blogs about how smoking can impact our mental health and urges the importance of smoking cessation.

Mary Yates and Steve Brine This year Mental Health Awareness week is focusing on stress and how we all cope with it.  Stress is something we all have to deal with when we are under pressure. Some people respond to the combination of physical and mental symptoms stress causes by smoking. Rather than improving the situation, smoking can add new problems, such as nicotine withdrawal symptoms these confused with stress and subsequently lead smokers to think that when they smoke their stress level is reduced.  In fact smoking does not reduce stress at all; it merely relieves the nasty nicotine withdrawal symptoms and in some cases causes more stress, such as health and financial worries.

[Image: Mr Steve Brine MP, Mary Yates and Dr Nicola Byrne]

Yesterday, Mr Steve Brine, MP and minister for public health, visited South London and Maudsley NHS Foundation Trust to see first-hand how the smokefree policy has been developed and implemented.  During the visit he heard about the commitment to support health and wellbeing through integrating research, education and clinical practice. Professor Ann McNeill, and Dr Debbie Robson from King’s College London, who lead on the research and education elements of the programme, were able to highlight how the translation of research into everyday care is possible because of King’s Health Partners.  Together with Andrew Koch, Tracy Davies and Melissa Wood, members of South London and Maudsley’s smokefree team, I was able to describe the ways in which we support smokers using our services.  A patient from Effra Ward in River House and another from Ruskin Ward in Maudsley Hospital participated in the meeting to share their personal smokefree stories.

One of the first achievements for Mr Brine in this parliament has been publication of Towards a Smokefree Generation - A Tobacco Control Plan for England in July 2017.  The goal to close the gap between the prevalence of smoking in the general population and those with mental health problems is given high priority in this ambitious plan.  However, around one third of mental health in-patient services have failed to implement a smoke free policy by January 2018 as desired. 

So what has made a difference in our Trust? Clearly, the dedicated smokefree specialists within in-patient services are an essential ingredient but creating an automated referral system that connects smokers with the specialists has been vital. Typically 80% of patients coming into South London and Maudsley NHS Foundation Trust are now asked if they smoke, given brief advice about smoking, and offered the opportunity to see a specialist if appropriate.  We’re doing this on the Physical Health Assessment part of our Electronic Patient Journey System (ePJS).

Recognising that smoking is detrimental to physical and mental health is also a very important aspect of engagement with this policy so that mental health care professionals see tobacco dependence treatment as being relevant to their scope of practice.  Within the hospital setting getting the balance right between the prompt access to nicotine replacement therapy and removal of cues to smoke to make it easier for every smoker to cut down and quit. 

I am delighted that across all South London and Maudsley hospital sites access to e-cigarettes is now easier with ISS supporting our campaign by selling e-burn disposable e-cigarettes within their retail outlets in Bethlem Royal, Maudsley and Lambeth hospitals.  Whilst in the Ladywell Unit in Lewisham Hospital a selection of Liberty Flights e-cigarettes are available to purchase.  Supporting switching to e-cigarettes is a realistic and achievable goal for many smokers as they get started on their smoke free journey.