Supporting people with Severe Mental Ill Health (SMI) to quit smoking



Developing and implementing a smoking intervention to help people with SMI cut down or quit smoking.


People with serious mental ill health are three to four times more likely to smoke than people in the general population. Smoking contributes to poor health, poverty and early death in people with SMI, who on average die 20 to 25 years earlier than those without. Smoking makes a significant contribution to this health inequality. Whilst smoking rates are falling in the general population, they have remained unchanged among people who use mental health services. For these reasons, it is clear that conventional approaches to smoking cessation might need to be tailored to people with SMI.

What our ARC is doing to help

Our Mental Health theme developed a bespoke smoking cessation (BSC) intervention to help people with serious mental illness cut down or quit smoking. The SCIMITAR+ (smoking cessation in people with serious mental illness) trial was conducted (following a successful pilot) to evaluate the clinical and cost effectiveness of the SCIMITAR intervention. This is the largest trial to facilitate quitting ever undertaken in mental health services and this was commissioned by NIHR.

Our findings

Participants who received the bespoke intervention were twice as likely to have quit smoking at 6 months, and a difference endured at 12 months. This research is directly informing national policy and practice around smoking cessation for people with severe mental illness (SMI), which should result in improved quit rates and, importantly better health for this group. Our findings have been included in the following:

  • NICE guideline NG209-Tobacco: preventing uptake, promoting quitting and treating dependence Adopted at a national policy level by NHS England and included in the NHS Long Term Plan
  • Community Mental Health (CMH) Tobacco Treatment Training Suite on the National Centre for Smoking Cessation Training (NCSCT)

14.2% STOPPED SMOKING at 6 months
15.2% STOPPED SMOKING at 12 months



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