Mental Health Smoking Cessation Interventions

This assignment analyzes various approaches to assisting individuals with serious mental illnesses in quitting smoking. It examines relevant research articles on the topic, including studies on the effectiveness of bespoke interventions and the perspectives of mental health professionals. Additionally, it delves into a qualitative study exploring service users' experiences with a specific tailored smoking cessation program. The analysis involves understanding key themes and insights from this user-centered research, highlighting the challenges and successes encountered during the quitting process.

EXPERIENCE OF SMOKING CESSATION
INITIATIVES FOR PEOPLE WITH MENTAL
HEALTH ISSUES

Introduction
In the modern era smoking has become the major problem in the nation. Now this issue
has become the public matter. Government is continuously working to minimise number of
smokers in the country (We need a strategy to help people with mental health problems quit
smoking, 2016). Previous records show that patients those who are experiencing mental illness
smoke regularly and due to this they have to face many other health problems. Statistical records
show that people those who are diagnosed with psychiatric disorder smoke 2-4 time more as
compared to general population (Making the journey with me: a qualitative study of experiences
of a bespoke mental health smoking cessation intervention for service users with serious mental
illness, 2016). It is fact that 1 up to 88% people those who are experiencing schizophrenia and
82.5% people those who are suffering from bipolar disorder smoke to great extent. These people
are addicted to use cigarettes. Medical professionals have to provide then high does medications
for improving their health.
Government of United Kingdom has increased tax rate on tobacco products. It was the
great initiative, after that people were unable to buy such smoking material easily. This has
supported in reducing number of smokers from the nation. In addition, authorities have taken
initiative to organize smoking cessation and health education campaigns (Knowles and et.al,
2016). In these camps medical professional provide in-depth knowledge to population about
drawbacks of using cigarettes and similar products. Apart from this, they make them aware with
the ways through which they can easily quit this smoking habit. Furthermore, printing health
warnings in bold on tobacco products is another smoking cessation initiative of the government.
All these actions have supported the government in reducing the death rate of mental patients
due to use of high amount of nicotinic products (Fazel, Geddes and Kushel, 2014).
The paper will examine the experience of smoking cessation initiatives for people those
who are suffering from mental health issues. In addition, research will explore systematic review
by paying attention on research questions. Furthermore, research will analyses significant of
ethical consideration. In addition, strength and weakness of methods will be explored.
Public Health England (2015) stated that UK has become the country where government
spendings are getting increased for controlling over smoking. Due to smoking, UK has become
the nation where premature death rate is high. In the year 2010 approx death were recorded
81700 and in the year 2015 it was 7900. 42% smokers are diagnosed with mental illness. Taylor

and et.al, (2014) government has organized an intensive tobacco treatment program. This
program has become successful and report shows that 600 smokers those who were living with
psychiatric comorbidities have participated in this camp and they have shown their interest. This
has helped in making this program successful. Due to smoking they had cancer but this program
has helped in recovering from cancer. These all involved patients were initially suffering from
depression, anxiety, stress. After joining this camp they have received treatment for their
psychiatric symptoms (Lawn and et.al, 2015).
Marshall, Kuiper and Lavinghouze, (2015) stated that Tobacco treatment program was
the main initiative of the government in which medical professionals have provided intensive
counselling to these patients. In this programs people those who were experiencing mental illness
and smoke regularly they get nicotine replacement therapy (NRT). This assists in improving their
health and they get recovered soon. As per the view of Lukowski and et.al, (2015) initiative have
made changes in the smoking habits of the person but due to this their metabolism get affected. It
is the fear that have occurred in front of medical professionals. It is very difficult for the nursing
staff to address smoking habit in the health care programs. Because mental patients do not
discuss their issues easily with practitioners. In such condition doctors fail to provide them
treatment as per their requirements.
Research question
What are the experiences of smoking cessation initiatives for people with mental health
issues?
AIM AND OBJECTIVES
The primary purpose of research question is to examine the success of smoking cessation
initiative of government. Its aim is to develop understanding about causes ad effects of smoking
in people with mental issues.
Significance of the study
Studies show that UK is the country where large number of population smoke and they
suffer from mental health issues. This has become the main cause of death in the nation, now it
has become the concern point for government, policy makers and NHS that to take some serious
initiatives for improving health of smokers those who are suffering from mental health problems.

This research will be significant for the other scholars, they will get the idea for
conducting study in future on the same subject. Furthermore, this would be beneficial for
government and policy makers. By this way, they will get to know effectiveness of smoking
cessation initiatives. This would be beneficial in identifying loop fall in the current policy and
initiatives so that government would be able to make changes in existing policy for the
betterment of patients with mental illness those who smoke regularly (Lukowski and et.al, 2015).
In addition, this research would be beneficial for the medical professionals they will get to know
standards and about cessation initiatives. By this way they will be able to improve their practices.
This will help in providing quality care services to patients.
Systematic review
Evidence based studies show that smoking is the main cause of cardiovascular disease in
the human being. WHO (2010) statistical report shows hat people those who smoke in excess are
more likely to suffer with mental health illness. As per the view of Fazel, Geddes and
Kushel, (2014) government is now much more active to reduce number of cases of death of
mental patients due to smoking. For that government of UK have made many laws and
regulations so that smoking habit can be quit by the population. One of the main initiative of
government is smoking warning on tobacco products. Now government has made it compulsory
to show warning on each cigarettes packets. By this way many people get to know that it is
injurious to health and they need to stop smoking. As per the report of 2011 after this cessation
initiatives 74% people those who were suffering from bipolar disorder have shown their desire to
quit this habit. This health warning has made people aware with the drawback of using tobacco
and they have quit this habit soon.
Public Health England (2015) stated that health care workers need to fulfil their
responsibilities effectively. This study describes the changes that need to be made by NHS in its
smoking policy for improving condition of nation and for protecting people.
Taylor and et.al, (2014) people those who are experiencing mental health issues have to
face many challenges. The main problem that is faced by these people is poor health and shorter
lives as compare to normal person. Whenever individual who already has mental illness
consumes cigarettes then their health conditions get worst. In such condition individual get
suffered from many other diseases that impacts on their life length. That is the main reason that

most of the mental patients get died soon. Statistical report of 2015 revealed that persons with
mental disorder lose their median of 10 years as compare to others from their life expectancies
due to use of tobacco in excess. Previous studies show that most of the mental patients suffer
from many others chronic disease due to smoking. Cofta-Woerpel and et.al, (2018) stated that
mental patients do not get equal response from the society members. In such condition they face
lonely and they suffer from many critical situations. In such condition these people feel so
dishearten and they move to wrong direction. Sometimes, due to their illness they do not get
equal job opportunities. That impacts on their economic status and they remain in stress. This is
the main reason that mental patients consumes high amount of cigarettes in their routine life as
compare to normal people.
Knowles and et.al, (2016) people those who are experiencing mental issues such as
schizophrenia, bipolar disorder etc. are weaker from others. Due to their poor health doctors have
to give high does medicines so that their health can get improved soon. In such condition their
other body parts sometimes fails to perform their work effectively. These high dose medicines
affect their liver, kidney etc. That later on creates critical situations for the person. Apart from
this mental patients have to face social isolation. That is the biggest challenge of these people.
Society does not accept such persons those who are facing some medical illness related with
their mental conditions. In such condition they fail to discuss their problems with others and they
feel alone. This increases stress, anxiety in their life which impacts on their life expectancies rate
to great extent.
The systematic review proves that smoking is developing psychiatric disorder in human
being. The systematic review show that smoking cessation initiatives need to be taken by the
government effectively and in such way so that mental health condition of human being can be
improved soon. Therefore, it is very important that medical professionals get adequate
information about current practices so that they can provide quality care services to mental health
patients and can make this smoking cessation initiatives successful.
Knowles and et.al, (2016) one of the main smoking cessation initiative of UK
government was increasing taxation rates on tobacco products. It was the major action that has
changed the scenario of this industry. Tobacco industry was contributing well in the economic
development of the nation but after this legislation people were unable to buy such costly
products (Fazel, Geddes and Kushel, 2014). This has supported in reducing sales volume of such

items. Banning smoking in public places was another initiative of health department and
government. Many psychiatric institutions have banned smoking in the internal and external
environment. Many public agencies such as Centres for disease control and prevention are
controlling over the academic organizations so that smoking cessation efforts can give positive
results to the society. Many health care camps have been organized by the medical professionals
with the combined efforts of government. In these camps, they have provided special treatment
to such people those who are suffering from mental illness. Medical professional have make
them aware with the drawback of tobacco and how they can quit this habit. This has helped many
patients in stopping smoking. This has also supported in improving their health conditions.
As per the view of Cofta-Woerpel and et.al, (2018) it is very difficult to make the
psychiatric patients understand with the drawback of smoking. Smoking cessation initiatives
have supported in reducing consumption of tobacco in these people. Initiative of giving health
warning on cigarettes packets have changed the view of mental people. Now they are more
interested in quitting this habit.
The main focus of research question is to minimize risk of smoking. For that medical
professional are required to monitor condition of patients effectively. They have to encourage the
care users when they refuse to attend smoking cessation programs.
Methods
For the current paper scholar will use Interpretative phenomenological analyses (IPA)
method. It is the methodology that explore the detail that how participants are making sense of
real world. The main objective of using this method is to involve particular experience, event
into the investigation (Interpretative phenomenological analysis, 2012). This tool helps in
examining participants life in depth. IPA explains that it is difficult to understand experience of
human being, their feeling and thinking. For understanding that researcher has to make
connection with people those who are in emotional and mental state.
As study is more interested in examining experience of smoking cessation initiative on
people with mental health problems. This approach will help in finding to what extent this
initiative is successful or unsuccessfully. IPA is helpful in understanding verbal and non verbal
words of the participants. By this way their experience with smoking cessation initiatives can be
identified (Interpretative phenomenological analysis, 2012).
Construction of research question and deciding sample

IPA is considered as suitable approach when researcher has to identify perception of
individual in particular situation or event. In the current research scholar will construct research
questions. All these questions will be broadly framed and are open. Researcher will not
formulate any hypotheses and will not test it (Flick, 2015).
IPA approach takes support of small sample sizes. In the current study researcher will use
homogeneous sample. Samples will be selected by using purposive sampling technique. By this
way individual will be able to define the group those who can give accurate answers of research
questions about experience of smoking cessation initiatives on people with mental health illness
(Interpretative Phenomenological Analysis, 2007.).
Data collection
IPA approach collects data from semi structured interview technique. It is considered as
most effective tool of gathering in-depth detail about the subject matter. IPA researches focus on
how participants think and perceive about the topic. There ae various data collection methods
such as interview, diaries, focus groups etc. In order to examine their sense it is essential to adopt
flexible data collection instrument. Interview allows the scholar in engaging the participants into
study and identifying their real experience (Interpretative phenomenological analysis, 2012). For
enhancing reliability of the data researcher will stick to the interview schedule. Scholar some
times will provide some options for answering the questions related with experience of smoking
cessation initiative on people with mental health issues. The semi structure interview will support
the researcher in asking questions as per the interview schedule. It will help the scholar in
flexibility of coverage and producing rich data (Interpretative Phenomenological Analysis,
2007.).
Constructing questions
Interviewer will start asking general questions about smoking cessation so that
participants can easily talk about. If any answers is unable to understand the question then
researcher will move to prompt that is more specific. Funnelling technique will be adopted by
scholar for construction of research questions (Interpretative Phenomenological Analysis, 2007.).
Analyses
IPA approach has assumption that researcher has more interest in knowing about
respondent's psychological world. For the analyses, researcher will adopt interpretative method

or relationship. Participants will be involved in the investigation as it is outline above
(Interpretative phenomenological analysis, 2012).
Researcher will adopt personal interview technique. Face to face interview will be
conducted in order to understand experience of people with mental illness about smoking
cessation initiatives. It is appropriate technique because by this way scholar can directly ask to
participants open ended questions related to subject matter (Interpretative Phenomenological
Analysis, 2007.).
Ethical consideration
Ethical aspects are most important part of dissertation, it is essential for the scholar that to
follow ethical aspects. Scholar will consider ethical aspects while collecting information about
the subject matter. The ethical aspect show that it is essential to consider welfare of participants
first in the researches. Scholar will follow this ethical aspect and will not involve any activity
that can harm the respondents.
Consent: Scholar will take permission of University and hospitals before starting the research on
its patients.
Autonomy: All participation will be aware with their rights and researcher will give them option
to give their views. Scholar will respect all individuals and will give them rights to take their
own decision without any force (Interpretative Phenomenological Analysis, 2007.).
Confidentiality: Scholar will maintain confidentiality and will not disclose any detail about
participants and other data with third person. Individual will protect data and will follow rules so
that reliable answers can be generated.
No harm: Investigator will not do any activity that can cause harm to any respondent. Researcher
will take consent of participants before involving them into the study.
Self awareness: Being a researcher individual is well aware with perception, values of patients.
Scholar will develop relationship with them in order to collect accurate information.
Researcher can face issue of complain by respondents. But before involving them into the
study scholar will send them consent form and after getting their consent investigator will
involve them in research. Furthermore, another challenge for the researcher is to get accurate
information (Brinkmann, 2014). For that scholar will access only authorized sites and will take
permission from higher authorities. Apart from this another ethical issue can arise in the
dissertation is related with plagiarism. In order to resolve this problem scholar will not copy any

material from any website. Scholar will develop understanding about the topic and will translate
it into own language (Lewis, 2015).
Interpersonal relationship
Researcher will concentrate on using professional skill so that healthy relationship can be
built up. Individual will ensure that all service users be protected and no harm occur during
investigation.
Personal reflection
Doing this research I have developed my research skills. I have developed my knowledge
that has supported me in understanding problematic nature. Research on smoking cessation
initiatives for people with mental illness can be better for me. By this way being a nurse I would
be able to improve my knowledge about mental patients, their issues and how they deal with
their problems. Furthermore, this investigation would be beneficial for me in improving my
knowledge about various smoking cessation initiates of government and its effectiveness. This
research can help me in improving my communication skill to great extent. As I would have to
coordinate with medical professional for gathering their views about the subject matter. Good
communication will help me in dealing with care users well and understanding their medical
problems effectively. My research skill would be developed with the assistance of this
investigation.
Strength and limitation of the research
As interest on certain aspect of illness is increasing thus IPA approach is most likely to
use in the field of psychology. It looks at the topic and collect in-depth understanding that helps
the researcher in developing knowledge and carry out the investigation in effective manner. It
maintains balance between phenomenological description and insight interpretation. It is flexible
and it concentrates on theoretical aspects and experience both. That is the main strength of IPA
method. This approach has considered as suitable in the health care studies. It helps in
identifying perception of human being. Scholar involves open ended questions that allows the
researcher to gather rich data (Interpretative phenomenological analysis, 2012).
But before applying this IPA method it is essential that researcher should have
interviewing skills. Otherwise, individual may get failed to collect relevant information about the
subject matter. It is very difficult to make connection with service users. They might not share
their experience with scholar.

Conclusion
Researcher has shown suitability of various research methods for examining the
experience of smoking cessation initiative on people with mental health issues. Systematic
review has been done in the above study. Lastly reliability, validity of the research questions
have been demonstrated.
Action plan
Researcher will have to develop research skills and will have to develop knowledge about
IPA approach. For that scholar will read articles that are based upon IPA method. Scholar will do
systematic review of earlier studies so that skill can be improved.

REFERENCES
Books and Journals
Brinkmann, S., 2014. Interview. In Encyclopedia of critical psychology (pp. 1008-1010).
Springer New York.
Cofta-Woerpel, L. and et.al., 2018. A Tele-mentoring Tobacco Cessation Case Consultation and
Education Model for Healthcare Providers in Community Mental Health Centers. Cogent
Medicine, (just-accepted). pp.1430652.
Fazel, S., Geddes, J. R. and Kushel, M., 2014. The health of homeless people in high-income
countries: descriptive epidemiology, health consequences, and clinical and policy
recommendations. The Lancet. 384(9953). pp.1529-1540.
Flick, U., 2015. Introducing research methodology: A beginner's guide to doing a research
project. Sage.
Knowles, S. and et.al., 2016. Making the journey with me: a qualitative study of experiences of
a bespoke mental health smoking cessation intervention for service users with serious
mental illness. BMC psychiatry. 16(1). pp.193.
Lawn, S. and et.al., 2015. Mental health professionals’ perspectives on the implementation of
smoke-free policies in psychiatric units across England. International Journal of Social
Psychiatry. 61(5). pp.465-474.
Lukowski, A. V. and et.al., 2015. Quitline outcomes for smokers in 6 states: rates of successful
quitting vary by mental health status. Nicotine & Tobacco Research. 17(8). pp.924-930.
Marshall, L. L., Kuiper, N. M. and Lavinghouze, S. R., 2015. Peer Reviewed: Strategies to
Support Tobacco Cessation and Tobacco-Free Environments in Mental Health and
Substance Abuse Facilities. Preventing chronic disease. 12.
Taylor, G. and et.al., 2014. Change in mental health after smoking cessation: systematic review
and meta-analysis. Bmj. 348. pp.g1151.
Taylor, S. J., Bogdan, R. and DeVault, M., 2015. Introduction to qualitative research methods:
A guidebook and resource. John Wiley & Sons.

Online
Making the journey with me: a qualitative study of experiences of a bespoke mental health
smoking cessation intervention for service users with serious mental illness, 2016.
[Online]. Available through
<https://pure.york.ac.uk/portal/files/49192591/art_10.1186_s12888_016_0901_y.pdf>
We need a strategy to help people with mental health problems quit smoking, 2016. [Online].
Available through <https://www.theguardian.com/society/2016/apr/13/smokers-mental-
health-poverty-inaction-scandal>
Public Health England (2015). Five million people at risk of Type 2 diabetes. Retrieved from
https://www.gov.uk/government/news/five-million.people-risk-of-type2-diabetes
Interpretative phenomenological analysis, 2012. [Online]. Available through <http://pure-
oai.bham.ac.uk/ws/files/10613882/larkin_m_thomson_a_r_IPA_chp08_methods_no_wat
e>
Interpretative Phenomenological Analysis, 2007. [Online]. Available through <http://med-fom-
familymed-research.sites.olt.ubc.ca/files/2012/03/IPA_Smith_Osborne21632.pdf>