Smoking cessation in persons with serious mental illnesses: the experience of successful quitters

The purpose of the study was to better understand the experiences of persons with serious mental illnesses who have quit smoking.

Former smokers with serious mental illnesses who had been abstinent for at least 4 months participated in an individually-administered structured interview about their motivation to quit smoking and the strategies that they used to quit. Participants also were asked about their willingness to assist peers in smoking cessation.

The sample of 78 successful quitters had been abstinent from smoking for an average of 7.4 (±8.6) years after smoking for a mean of 25.3 (±11.4) years; the mean peak quantity of cigarettes smoked was 1.5 (± 1.1) packs per day. The primary reason for quitting smoking was health concerns, endorsed by 57 (73%) of respondents. Additional reasons included the cost of cigarettes (55, 71%); advice from a doctor (42, 54%); advice from others (50, 64%). The main methods that participants cited as enabling them to quit were social support from friends or family (cited by 45, 58%); direction from a doctor (36, 46%); use of nicotine replacement therapy (NRT) (24, 31%); and the advice of friends who had quit (18, 23%). Only a small proportion of the sample had received smoking cessation treatment other than NRT. A large portion of the sample indicated that they would be willing to serve in peer helping roles for smoking cessation.

Persons with serious mental illnesses are able to successfully quit smoking despite extensive histories of heavy smoking. For practitioners, this study also emphasizes the importance of smoking cessation programming that is relevant and easily accessible to people with serious mental illnesses. Importantly, former smokers living with mental illnesses indicated a willingness to be involved in helping others quit, and should be utilized in formal smoking cessation efforts aimed at their peers.