Intended for healthcare professionals

CCBYNC Open access

Rapid response to:

Research

Change in mental health after smoking cessation: systematic review and meta-analysis

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1151 (Published 13 February 2014) Cite this as: BMJ 2014;348:g1151

Rapid Response:

Re: Change in mental health after smoking cessation: systematic review and meta-analysis

We included four studies which examined change in mental health outcomes in people with psychiatric illnesses. Diagnoses included: past major depression, current depressive disorders and people with post-traumatic stress disorder. In a further two studies the participants were diagnosed with chronic physical and/or psychiatric conditions including, depression, anxiety, and schizophrenia, bipolar and other emotional difficulties. The direction of the association in these studies did not differ in comparison to the general populations.

There is evidence to suggest that, at the very least; cessation is not associated with harm to the mental health of those with severe psychiatric illness. Banham and Gilbody (Banham & Gilbody 2010) reviewed eight randomised trials of cessation interventions versus no intervention in people with psychotic disorders. Six of the eight trials reported no difference in psychological outcomes after cessation and two showed better function in the cessation support arm. This paper did not report outcomes by cessation status so it is not possible to examine whether achievement of cessation is associated with improved psychological outcome. However the trial design strengthens the argument on causality and excludes the possibility that supporting cessation leads to substantial psychological harm.

References

Banham, L. & Gilbody, S. 2010, "Smoking cessation in severe mental illness: what works?", Addiction, vol. 105, no. 7, pp. 1176-1189.

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: GT has received grants and personal fees from a National Coordinating Centre for Research Capacity Development scholarship, during the conduct of the study; and personal fees from UK Centre for Tobacco and Alcohol Studies, outside the submitted work. AMcN has received grants from UK Centre for Tobacco and Alcohol Studies, outside the submitted work. AF has received grants from National Prevention Research Initiative, during the conduct of the study; and sat on the professional development group for NICE guidance on stopping smoking in secondary care. NL-H has received personal fees from manufacturers of smoking cessation aids, outside the submitted work; and manages an NIHR HTA funded trial of nicotine patch preloading. The nicotine patches for the trial are provided free of charge by GlaxoSmithKline (GSK). GSK have no other involvement in the trial. PA has received personal fees from Pfizer, grants and personal fees from McNeil, outside the submitted work.

27 February 2014
Gemma Taylor
Doctoral Researcher
Paul Aveyard, Ann McNeill, Nicola Lindson-Hawley, Amanda Farley
The University of Birmingham
Health and Populations Sciences