Does Spirituality Play a Role in Smoking Cessation? A Case Study Report of a Smoking Cessation Programme on Service Users with Schizophrenia
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Published
Dec 31, 2013
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Abstract
Nicotine addiction is a public health problem that increases medical
morbidity and mortality. Individuals with mental distress have higher rates of
smoking and poorer cessation outcomes than those without mental distress.
Individuals with schizophrenia tend to smoke more that those with other
diagnostic categories. They are also more likely to smoke high-tar cigarettes
than individuals with other forms of mental distress. They are therefore not
only more likely to be addicted to nicotine, but they are also at an increased
risk of developing serious health complications. Despite these factors,
individuals with schizophrenia are generally unlikely to seek help to quit
smoking, a function of decreased level of motivation and inability to do so.
They are rarely involved in smoking cessation activities.
Against this background, The aim of this study was to explore the
effectiveness of an integrated smoking cessation programme in enabling
service users to stop smoking. This article describes the application of this
programme on service users with schizophrenia and nicotine addiction. It
also describes roles played by its components in smoking cessation.
morbidity and mortality. Individuals with mental distress have higher rates of
smoking and poorer cessation outcomes than those without mental distress.
Individuals with schizophrenia tend to smoke more that those with other
diagnostic categories. They are also more likely to smoke high-tar cigarettes
than individuals with other forms of mental distress. They are therefore not
only more likely to be addicted to nicotine, but they are also at an increased
risk of developing serious health complications. Despite these factors,
individuals with schizophrenia are generally unlikely to seek help to quit
smoking, a function of decreased level of motivation and inability to do so.
They are rarely involved in smoking cessation activities.
Against this background, The aim of this study was to explore the
effectiveness of an integrated smoking cessation programme in enabling
service users to stop smoking. This article describes the application of this
programme on service users with schizophrenia and nicotine addiction. It
also describes roles played by its components in smoking cessation.
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Sandy, P. (2013). Does Spirituality Play a Role in Smoking Cessation? A Case Study Report of a Smoking Cessation Programme on Service Users with Schizophrenia. Alternation Journal, (11), 273-294. Retrieved from https://journals.ukzn.ac.za/index.php/soa/article/view/412
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Ashton, M, CL Miller, JA Bowden, S Bertossa 2010. People with Mental
Illness can Tackle Tobacco. Australia and New Zealand Journal of
Psychiatry 44: 1021 - 1028.
Banham, L, S Gilbody 2010. Smoking Cessation in Severe Mental Illness:
What Works? Addiction 105:1176 - 1189.
Bao, Y, N Duan & SA Fox 2006. Is Some Provider Advice on Smoking
Cessation Better than No Advice? An Instrumental Variable Analysis of
the 2002 National Health Interview Survey. Health Service Research 41:
2114 - 2135.
Barnes, M, BR Lawford, SC Burton, KR Heslop, EP Noble, K Hausdorf & R
Young 2006. Smoking and Schizophrenia: Is Symptom Profile Related to
Smoking and which Antipsychotic Medication is of Benefit in Reducing
Cigarette Use? Royal Australian and New Zealand College of
Psychiatrists 576 - 579.
Borras, L, Y Khazaal, R Khan, S Mohr & Y Kaufmann 2010. The
Relationship between Addiction and Religion and its Implication for
Care. Substance Use and Misuse 45: 2357 - 2410.
Burke, BL, H Arkowitz, M Menchola 2003. The Efficacy of Motivational
Interviewing: A Meta-analysis of Controlled Clinical Trials. Journal of
Consulting and Clinical Psychology 71: 843-861
Centers for Disease Control and Prevention (CDC) 2009. Cigarette Smoking
among Adults and Trends in Smoking Cessation - United States, 2008.
Morbidity and Mortality Weekly Report 58,44: 1227 - 1232.
Chapman, S, M Ragg, K McGeechan 2009. Citation Bias in Reported
Smoking Prevalence in People with Schizophrenia. Australia and New
Zealand Journal of Psychiatry 43: 277 - 282.
De Leon, J, FJ Diaz, E Becona, M Gurpegui, D Jurado 2003. Exploring Brief
Measures of Nicotine Dependence for Epidemiological Surveys.
Addiction Behaviours 28,8: 1481 - 1486.
Delaney, HD, AA Forcehimes, WP Campbell, BW Smith 2009. Integrating
Spirituality into Alcohol Treatment. Journal of Clinical Psychology 65,2:
185 - 198.
Dew, RE, SS Daniel, TD Armstrong, DB Goldston, MF Triplett 2008.
Religion or Spirituality and Adolescent Psychiatric Symptoms: A
Review. Child Psychiatry and Human Development 39: 381-398.
Difranza, J 2010. A New Approach to the Diagnosis of Tobacco Addiction.
Addiction 105: 381 - 282.
El-Guebaly, N, C Cathcart, S Currie, D Brown, S Gloster 2002. Smoking
Cessation Approaches for Persons with Mental Illness or Addictive
Disorders. Psychiatric Services 53:1166 - 1170.
Evins, AE, C Cather, R Deckersbach 2005. A Double Blind Placebo
Controlled Trial of Bupropion Sustained Release for Smoking Cessation
in Schizophrenia. Journal of Clinical Psychopharmacology 25,3: 218 -
225.
Fagerström, KO, NG Scheider 1989. Measuring Nicotine Dependence: A
Review of the Fagerström Tolerance Questionnaire. Journal of
Behaviour Medicine 12: 159 - 182.
Frankl, V 1978. The Unheard Cry for Meaning. New York, Simon &
Schuster.
Ganga, NS, VR Kutty 2012. Influence of Religion, Religiosity and Spirituality
on Positive Mental Health of Young People. Mental Health and
Religion 16,4: 435 - 443.
Geppert, C, MP Bogenschutz & WR Miller 2007. Development of a
Bibliography on Religion, Spirituality and Addictions. Drug and Alcohol
Review 26:389 - 395.
Hall, S, VI Reus & RF Munoz 1998. Nortriptyline and Cognitive Behaviour
Therapy in the Treatment of Cigarette Smoking. Archives of General
Psychiatry 55: 683 - 689.
Joseph, AM, SM Norman & LH Ferry 1996. The Safety of Transdermal
Nicotine as an Aid to Smoking Cessation in Patients with Cardiac
Diseases. Northern England Journal of Medicine 335: 1792 - 1798.
Josephson, AM, ML Dell 2004. Religion and Spirituality in Child and
Adolescent Psychiatry: A New Frontier. Child Adolescent Psychiatry
Clin N Am 13:1 - 15.
Keizer, I, Eytan A 2005. Variations in Smoking during Hospitalisation in
Psychiatric In-patient Units and Smoking Prevalence in Patient and
Healthcare Staff. Int. Journal of Social Psychiatry 5,4: 317 -328.
Kisely, S, LA Campbell 2008. Use of Smoking Cessation Therapies in
Individuals with Psychiatric Illness: An Update for Prescribers. CNS
Drugs 22,4: 263 - 273.
Koenig, HG 2009. Research on Religion, Spirituality and Mental Health: A
Review. Canadian Journal of Psychiatry 54,5: 283 - 291.
Koening, HG, ME McCullough & DB Larson 2001. Handbook of Religion
and Health. New York: Oxford University Press.
Kurdyak, P, J Cairney , A Sarnocinska-Hart, RC Callahan & C Strike 2008.
The Impact of Smoking Cessation Policy on Visits to a Psychiatric
Emergency Department. Canadian Journal of Psychiatry 53,11: 779 –
782.
Mathews, AM, VB Wilson & SH Mitchell 2011. The Role of Antipsychotics
in Smoking and Smoking Cessation. CNS Drugs 25,4: 299 - 315.
Miller, BJ, CB Paschall & DP Svendsen 2006. Mortality and Medical
Comorbidity among Patients with Serious Mental Illness. Psychiatric
Services 57:1482 - 1487.
Miller, WR & S Rollnick 2002. Motivational Interviewing: Preparing
People for Change. 2nd Edition. New York: Guildford
National Institute of Health and Clinical Excellence (NICE) 2007. Smoking
Cessation Services, Including the Use of Pharmacotherapies, in Primary
Care, Pharmacies, Local Authorities and Workplaces. London: NICE
Nock, MK, AE Kazdin 2005. Randomised Controlled Trial of a Brief
Intervention for Increasing Participation in Parent Management Training.
Journal of Consulting and Clinical Psychology 73: 872 - 879.
Secretan, B 2009. A Review of Human Carcinogens Part E: Tobacco, Areca
Nut, Alcohol, Coal smoke, and Salted Fish. Lancet Oncology 10,11:
1033 - 1034.
Shafey, O, S Dolwick & G Guindon 2003. Tobacco Control Country
Profiles. Atlanta, GA: American Cancer Society, World Health
Organization, and International Union against Cancer.
Shafey, O, M Eriksen, H Ross & J Mackay 2010. The Tobacco Atlas. 3rd
Edition. American Cancer Society. Available at: http://www.cancer.org/
AboutUs/GlobalHealth/CancerandTobaccoControlResources/the-tobacco
-atlas-3rd-edition.
Siru, R, GK Hulse, RJK Khan & R Tait 2010. Motivation to Quit Smoking
among Hospitalised Individuals With and Without Mental Health
Disorders. Australia and New Zealand Journal of Psychiatry 44: 640 -
647.
Solty, H, D Crockford, WD White & S Currie 2009. Cigarette Smoking,
Nicotine Dependence, Motivation for Smoking Cessation in Psychiatric
Inpatients. The Canadian Journal of Psychiatry 54,1: 36 - 34.
Steinberg, ML, DM Ziedonis, JA Krejci & TH Brandon 2004. Motivational
Interviewing with Personalised Feedback: A Brief Intervention for
Motivating Smokers with Schizophrenia to Seek Treatment for Tobacco
Dependence. Journal Consulting and Clinical Psychology 72,4: 723 -
728.
Takeuchi, T, M Nakao, Y Shinozaki , E Yano 2010. Validity of Self-report
Smoking in Schizophrenia Patients. Psychiatric and Clinical
Neurosciences 64: 274 - 278.
World Health Organisation (WHO) 2009. World Health Organization
Regional Office for the Western Pacific. Geneva: WHO.
World Health Organisation (WHO) 1998. Guidelines for Controlling and
Monitoring the Tobacco Epidemic. Geneva: WHO.
Hammond, SK 2009. Global Patterns of Nicotine and Tobacco Consumption.
Handbook of Experimental Pharmacology 192:3 - 28. Available at:
http://www.springerlink.com/content/t353k255747342h6/.
Heatherton, TF, LT Kozlowski, RC Frecker & KO Fagerström 1991. The
Fagerström Test for Nicotine Dependence: A Revision of the Fagerström
Tolerance Questionnaire. British Journal of Addiction 86: 1119 - 1127.
Heatherton, TF, LT Kozlowski, RC Frecker, WS Rickert, J Robinson 1989.
Measuring the Heaviness of Smoking to First Cigarette of the Day and
the Number of Cigarettes Smoked per Day. British Journal of Addiction
84: 791 - 800.
Hettema, JE, PS Hendricks 2010. Motivational Interviewing for Smoking
Cessation: A Meta-analytical Review. Journal of Consulting and
Clinical Psychology 78,6: 868 - 884.
Hetteman, J, J Steele & WR Miller 2005. Motivational Interviewing. Annual
Review of Clinical Psychology 1: 91 - 111.
Hitsman, B, TG Moss, ID Montoya, TP George 2009. Treatment of Tobacco
Dependence in Mental Health and Addictive Disorder. Canadian Journal
of Psychiatry 54,6:368 - 378.
Hurt, RD, KM Eberman & BM Gerber 2007. Intention to Quit Tobacco Use
among Clients in Substance Use Disorder Treatment settings. Substance
Use and Misuse 42: 871 - 879.
Illness can Tackle Tobacco. Australia and New Zealand Journal of
Psychiatry 44: 1021 - 1028.
Banham, L, S Gilbody 2010. Smoking Cessation in Severe Mental Illness:
What Works? Addiction 105:1176 - 1189.
Bao, Y, N Duan & SA Fox 2006. Is Some Provider Advice on Smoking
Cessation Better than No Advice? An Instrumental Variable Analysis of
the 2002 National Health Interview Survey. Health Service Research 41:
2114 - 2135.
Barnes, M, BR Lawford, SC Burton, KR Heslop, EP Noble, K Hausdorf & R
Young 2006. Smoking and Schizophrenia: Is Symptom Profile Related to
Smoking and which Antipsychotic Medication is of Benefit in Reducing
Cigarette Use? Royal Australian and New Zealand College of
Psychiatrists 576 - 579.
Borras, L, Y Khazaal, R Khan, S Mohr & Y Kaufmann 2010. The
Relationship between Addiction and Religion and its Implication for
Care. Substance Use and Misuse 45: 2357 - 2410.
Burke, BL, H Arkowitz, M Menchola 2003. The Efficacy of Motivational
Interviewing: A Meta-analysis of Controlled Clinical Trials. Journal of
Consulting and Clinical Psychology 71: 843-861
Centers for Disease Control and Prevention (CDC) 2009. Cigarette Smoking
among Adults and Trends in Smoking Cessation - United States, 2008.
Morbidity and Mortality Weekly Report 58,44: 1227 - 1232.
Chapman, S, M Ragg, K McGeechan 2009. Citation Bias in Reported
Smoking Prevalence in People with Schizophrenia. Australia and New
Zealand Journal of Psychiatry 43: 277 - 282.
De Leon, J, FJ Diaz, E Becona, M Gurpegui, D Jurado 2003. Exploring Brief
Measures of Nicotine Dependence for Epidemiological Surveys.
Addiction Behaviours 28,8: 1481 - 1486.
Delaney, HD, AA Forcehimes, WP Campbell, BW Smith 2009. Integrating
Spirituality into Alcohol Treatment. Journal of Clinical Psychology 65,2:
185 - 198.
Dew, RE, SS Daniel, TD Armstrong, DB Goldston, MF Triplett 2008.
Religion or Spirituality and Adolescent Psychiatric Symptoms: A
Review. Child Psychiatry and Human Development 39: 381-398.
Difranza, J 2010. A New Approach to the Diagnosis of Tobacco Addiction.
Addiction 105: 381 - 282.
El-Guebaly, N, C Cathcart, S Currie, D Brown, S Gloster 2002. Smoking
Cessation Approaches for Persons with Mental Illness or Addictive
Disorders. Psychiatric Services 53:1166 - 1170.
Evins, AE, C Cather, R Deckersbach 2005. A Double Blind Placebo
Controlled Trial of Bupropion Sustained Release for Smoking Cessation
in Schizophrenia. Journal of Clinical Psychopharmacology 25,3: 218 -
225.
Fagerström, KO, NG Scheider 1989. Measuring Nicotine Dependence: A
Review of the Fagerström Tolerance Questionnaire. Journal of
Behaviour Medicine 12: 159 - 182.
Frankl, V 1978. The Unheard Cry for Meaning. New York, Simon &
Schuster.
Ganga, NS, VR Kutty 2012. Influence of Religion, Religiosity and Spirituality
on Positive Mental Health of Young People. Mental Health and
Religion 16,4: 435 - 443.
Geppert, C, MP Bogenschutz & WR Miller 2007. Development of a
Bibliography on Religion, Spirituality and Addictions. Drug and Alcohol
Review 26:389 - 395.
Hall, S, VI Reus & RF Munoz 1998. Nortriptyline and Cognitive Behaviour
Therapy in the Treatment of Cigarette Smoking. Archives of General
Psychiatry 55: 683 - 689.
Joseph, AM, SM Norman & LH Ferry 1996. The Safety of Transdermal
Nicotine as an Aid to Smoking Cessation in Patients with Cardiac
Diseases. Northern England Journal of Medicine 335: 1792 - 1798.
Josephson, AM, ML Dell 2004. Religion and Spirituality in Child and
Adolescent Psychiatry: A New Frontier. Child Adolescent Psychiatry
Clin N Am 13:1 - 15.
Keizer, I, Eytan A 2005. Variations in Smoking during Hospitalisation in
Psychiatric In-patient Units and Smoking Prevalence in Patient and
Healthcare Staff. Int. Journal of Social Psychiatry 5,4: 317 -328.
Kisely, S, LA Campbell 2008. Use of Smoking Cessation Therapies in
Individuals with Psychiatric Illness: An Update for Prescribers. CNS
Drugs 22,4: 263 - 273.
Koenig, HG 2009. Research on Religion, Spirituality and Mental Health: A
Review. Canadian Journal of Psychiatry 54,5: 283 - 291.
Koening, HG, ME McCullough & DB Larson 2001. Handbook of Religion
and Health. New York: Oxford University Press.
Kurdyak, P, J Cairney , A Sarnocinska-Hart, RC Callahan & C Strike 2008.
The Impact of Smoking Cessation Policy on Visits to a Psychiatric
Emergency Department. Canadian Journal of Psychiatry 53,11: 779 –
782.
Mathews, AM, VB Wilson & SH Mitchell 2011. The Role of Antipsychotics
in Smoking and Smoking Cessation. CNS Drugs 25,4: 299 - 315.
Miller, BJ, CB Paschall & DP Svendsen 2006. Mortality and Medical
Comorbidity among Patients with Serious Mental Illness. Psychiatric
Services 57:1482 - 1487.
Miller, WR & S Rollnick 2002. Motivational Interviewing: Preparing
People for Change. 2nd Edition. New York: Guildford
National Institute of Health and Clinical Excellence (NICE) 2007. Smoking
Cessation Services, Including the Use of Pharmacotherapies, in Primary
Care, Pharmacies, Local Authorities and Workplaces. London: NICE
Nock, MK, AE Kazdin 2005. Randomised Controlled Trial of a Brief
Intervention for Increasing Participation in Parent Management Training.
Journal of Consulting and Clinical Psychology 73: 872 - 879.
Secretan, B 2009. A Review of Human Carcinogens Part E: Tobacco, Areca
Nut, Alcohol, Coal smoke, and Salted Fish. Lancet Oncology 10,11:
1033 - 1034.
Shafey, O, S Dolwick & G Guindon 2003. Tobacco Control Country
Profiles. Atlanta, GA: American Cancer Society, World Health
Organization, and International Union against Cancer.
Shafey, O, M Eriksen, H Ross & J Mackay 2010. The Tobacco Atlas. 3rd
Edition. American Cancer Society. Available at: http://www.cancer.org/
AboutUs/GlobalHealth/CancerandTobaccoControlResources/the-tobacco
-atlas-3rd-edition.
Siru, R, GK Hulse, RJK Khan & R Tait 2010. Motivation to Quit Smoking
among Hospitalised Individuals With and Without Mental Health
Disorders. Australia and New Zealand Journal of Psychiatry 44: 640 -
647.
Solty, H, D Crockford, WD White & S Currie 2009. Cigarette Smoking,
Nicotine Dependence, Motivation for Smoking Cessation in Psychiatric
Inpatients. The Canadian Journal of Psychiatry 54,1: 36 - 34.
Steinberg, ML, DM Ziedonis, JA Krejci & TH Brandon 2004. Motivational
Interviewing with Personalised Feedback: A Brief Intervention for
Motivating Smokers with Schizophrenia to Seek Treatment for Tobacco
Dependence. Journal Consulting and Clinical Psychology 72,4: 723 -
728.
Takeuchi, T, M Nakao, Y Shinozaki , E Yano 2010. Validity of Self-report
Smoking in Schizophrenia Patients. Psychiatric and Clinical
Neurosciences 64: 274 - 278.
World Health Organisation (WHO) 2009. World Health Organization
Regional Office for the Western Pacific. Geneva: WHO.
World Health Organisation (WHO) 1998. Guidelines for Controlling and
Monitoring the Tobacco Epidemic. Geneva: WHO.
Hammond, SK 2009. Global Patterns of Nicotine and Tobacco Consumption.
Handbook of Experimental Pharmacology 192:3 - 28. Available at:
http://www.springerlink.com/content/t353k255747342h6/.
Heatherton, TF, LT Kozlowski, RC Frecker & KO Fagerström 1991. The
Fagerström Test for Nicotine Dependence: A Revision of the Fagerström
Tolerance Questionnaire. British Journal of Addiction 86: 1119 - 1127.
Heatherton, TF, LT Kozlowski, RC Frecker, WS Rickert, J Robinson 1989.
Measuring the Heaviness of Smoking to First Cigarette of the Day and
the Number of Cigarettes Smoked per Day. British Journal of Addiction
84: 791 - 800.
Hettema, JE, PS Hendricks 2010. Motivational Interviewing for Smoking
Cessation: A Meta-analytical Review. Journal of Consulting and
Clinical Psychology 78,6: 868 - 884.
Hetteman, J, J Steele & WR Miller 2005. Motivational Interviewing. Annual
Review of Clinical Psychology 1: 91 - 111.
Hitsman, B, TG Moss, ID Montoya, TP George 2009. Treatment of Tobacco
Dependence in Mental Health and Addictive Disorder. Canadian Journal
of Psychiatry 54,6:368 - 378.
Hurt, RD, KM Eberman & BM Gerber 2007. Intention to Quit Tobacco Use
among Clients in Substance Use Disorder Treatment settings. Substance
Use and Misuse 42: 871 - 879.