Overcoming the barriers to quitting smoking

How can we help patients in mental health units to ditch the habit of a lifetime? Melissa Wood from South London and Maudsley NHS Foundation Trust shares her experiences.

As a Tobacco Dependence Advisor I hear the concerns and nerves every day from service users about quitting.

Whilst I would love all the patients to quit smoking I appreciate the massive barriers they have to overcome to even go smokefree whilst in hospital.

We have been smokefree on all South London and Maudesley NHS Foundation Trust sites since October 2014 and it’s been quite a journey. The smoking prevalence in the general population is now 15% but compared to 80% on some of our inpatient wards we can see the massive health inequalities patients face. They can expect to die some 20 years earlier and are at higher risk of developing lung disease, cancers, and other smoking related problems.

[Image: Melissa (left) works in the smokefree team at South London and Maudsley NHS Foundation Trust]

I am a member of the smokefree team, an amazing group of people that advocate for physical health within a mental health care setting. 

Do smokers with mental health problems want to quit?

As a Tobacco Dependence Advisor based in an inpatient setting I can say from experience that most of the smokers I work with want to quit. But smoking has been a huge part of people’s lives and has been considered a “constant friend”. All smokers worry about what they will do instead? How will they cope with boredom and stress?

For some smokers admission to a smokefree hospital provides them with the opportunity to quit tobacco and this can yield huge benefits.

We provide support to all inpatient smokers and talk about alternatives to smoking such as NRT (Nicotine Replacement Therapy) and E-Cigarettes. We use evidence based therapies to support patients manage their withdrawals from nicotine.

It is a step on the journey to be completely smokefree in the future.

During this last year, together with colleagues at the Ladywell Unit, I have supported 38 smokers to quit. I am very proud of this because I know that taking control of smoking has far reaching positive implications.

One patient said to me “everything is better in my life now I have stopped smoking and I don’t miss anything about it”.

My work also involves providing behavioural support for life beyond the unit, particularly around high risk situations when smokers are likely to have the urge to smoke. We help to strengthen their resolve to engage in more healthy pursuits to manage the stresses and strains of life.

What else is happening?

It’s nearly the end of Stoptober – the annual event to encourage smokers to quit for 28 days in October – with the aim of stopping smoking permanently.  This means it’s a particularly busy time of the year for me - facilitating market stalls and running educational sessions.

The tobacco harm reduction targets are driving improvements in the screening of all smokers, provision of brief advice and referral for support. South London and Maudsley NHS Foundation Trust has also launched a new physical health strategy – in which it recognises that effective tobacco dependence treatment across the pathway will yield the largest positive health benefits for smokers… It looks like I’m in for another busy year!

Visit King’s Health Partners Mind & Body to find out more about how we’re driving integrated mental and physical healthcare.