Health Professionals

1
Empowering psychiatric services to deal with
tobacco control
Göran Boëthius MD, PhD Tobacco Control
Unit Östersund Hospital Sweden Chair Doctors
Against Tobacco 13th International Conference
on Health Promoting Hospitals Dublin May 19, 2005
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Smoking rates by mental health disorders (HDA
2004)
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Smoking among the mentally ill

• Often heavy smokers
• Makes them very sick
• Social welfare says quit first
• Many want to quit
• Its almost impossible to quit without adequate
  support
• Its almost impossible to get adequate support

4
Smoking cessation

• Its important to support psychiatric patients
  in smoking cessation
• There are effective treatments
• The treatment should be adjusted to the
  psychiatric patients special needs

5
The Quitting Process I

• Plan the cessation process
• Strong nicotine dependence
• The disease in itself can prolong and complicate
  the process
• Intensive support over a long time

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The Quitting Process II

• Nicotine replacement therapy (NRT) effective
• Bupropion (Zyban) - great care
• Depression - risk of new episode
• Monitor blood levels of neuroleptics

7
Policy recommendations for psychiatric care

• All psychiatric units should be smoke-free
• Provide NRT generously
• All professionals should be trained

8

• Its cynical to treat the psychiatric disorder
  and leave the patient to die from smoking

9
For more information

• Barbro Holm Ivarsson, Psychologists against
  Tobacco
• barbro.holm-ivarsson_at_fhi.se
• Göran Boëthius, Doctors Against Tobacco
• goran.boethius_at_jll.se
• Katarina Törnqvist, Nurses Against Tobacco
• katarina.tornqvist_at_sll.se
• Carina Altsjö, Pharmacy Against Tobacco
• carina.altsjo_at_apoteket.se