Program Evaluation for a Novel Multicomponent Smoking Cessation Intervention for Smokers With Serious Mental Illness

People with serious mental illness (SMI) are more likely to smoke and less likely to quit than the general population. More effective and accessible cessation treatments are needed to promote health and prevent disease in this disparity population. To this end, we optimized a multicomponent health promotion intervention tailored for people with SMI, Breathe Well, Live Well, and conducted a quasi-experimental program evaluation to assess program feasibility and effectiveness compared with a usual care comparison condition consisting of "The 3 As." Community mental health center staff trained as health coaches delivered eight telehealth Breathe Well, Live Well sessions over 4 months to individuals. Breathe Well, Live Well content included cognitive behavioral therapy (CBT)-based counseling, pharmacotherapy support, incentivized app use (National Cancer Institute's quitSTART), and social support person coaching. Participants were 170 integrated mental health and primary care service recipients with SMI who smoked daily; 53 Breathe Well, Live Well and 117 comparison participants were enrolled during February 2020 through July 2022. Effectiveness was measured via biologically verified abstinence; feasibility was measured via Breathe Well, Live Well intervention engagement. Participants of Breathe Well, Live Well were about three times more likely to be abstinent at follow-up compared with comparison participants. Among those still smoking, Breathe Well, Live Well participants were about five times more likely to have decreased their daily cigarette consumption by at least half. Intervention engagement was strong for pharmacotherapy, counseling, and incentivized quitSTART app use, indicating that these components were feasible to deliver by community mental health center staff.