Through the Lens of Psychiatrists: Understanding Smoking Cessation Behaviour Among People with Serious Mental Illness

Smoking among people with Serious Mental Illness (SMI) is a pleading public health concern as the rates are much higher compared to the general population. Although different interventions are available to provide cessation support, there is limited evidence of assessing psychiatrists' perspectives on smoking cessation among people with SMI. The study aims to explore the perspectives of psychiatrists regarding smoking cessation among people with SMI. The study used a qualitative approach. In-depth interviews were conducted with ten psychiatrists, exploring their opinions about smoking and its cessation among people with SMI. Purposive sampling was employed. Data saturation was achieved when no new information was gathered. The verbatim transcripts were analysed using thematic analyses. A total of 14 subthemes emerged under seven themes, highlighting the perspective of psychiatrists in terms of the utilisation of smoking as a coping mechanism among people with SMI. Findings, such as priority of care, time constraints and patient initiative, emphasised the factors impacting cessation. Psychiatrists expressed that support from peers and family members significantly influences smoking cessation among people with SMI. Furthermore, merely engaging in asking, assessing and advicing components from the World Health Organisation 5As scale implied insufficient usage of the 5As tool while discussing cessation. Psychiatrists recognise the impact of cessation on mental health outcomes, like the utilisation of smoking as a coping mechanism. Their experiences and challenges with cessation highlighted time commitment and priority of care while contemplating cessation. The deepened insight provided by our study findings has been instrumental in shaping the content of tailored interventions related to smoking cessation among people with SMI.