1
|
Naylor H, Howie A, Every-Palmer S. Vaping in mental health inpatient units: A qualitative study of consumer and staff views on electronic nicotine delivery systems. Australas Psychiatry 2024; 32:230-234. [PMID: 38430065 DOI: 10.1177/10398562241236634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
OBJECTIVES The aim of this qualitative study was to explore the subjective experiences of consumers and staff members regarding the availability of electronic nicotine delivery systems (ENDS) in inpatient mental health units. METHODS Mental health consumers and staff members (n = 16) from rehabilitation and forensic inpatient units were interviewed in 2022. Thematic analysis of the transcripts was undertaken. RESULTS Our study identified four themes: The high salience of nicotine use in inpatient units, delivering nicotine in a resource scarce environment, weighing up the harms of ENDS as a smoking cessation tool, and a need for fair and consistent policy. CONCLUSIONS The main positive aspects identified were recognition of rights of consumers, a relative harm reduction compared to tobacco use, and ENDS as a positive factor in the therapeutic relationship. The main challenges identified were resourcing issues, ENDS being a potential source of tension and conflict and a lack of overarching policy guiding their use.
Collapse
Affiliation(s)
- Henry Naylor
- Mental Health, Addictions and Intellectual Disability Services 3DHB, Wellington, New Zealand
| | - Alex Howie
- Mental Health, Addictions and Intellectual Disability Services 3DHB, Wellington, New Zealand
| | - Susanna Every-Palmer
- Mental Health, Addictions and Intellectual Disability Services 3DHB, Wellington, New Zealand
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| |
Collapse
|
2
|
Britton M, Rogova A, Chen TA, Martinez Leal I, Kyburz B, Williams T, Patel M, Reitzel LR. Texas tobacco quitline knowledge, attitudes, and practices within healthcare agencies serving individuals with behavioral health needs: A multimethod study. Prev Med Rep 2023; 35:102256. [PMID: 37752980 PMCID: PMC10518765 DOI: 10.1016/j.pmedr.2023.102256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/18/2023] [Accepted: 05/19/2023] [Indexed: 09/28/2023] Open
Abstract
Patients with behavioral health conditions have disproportionately high tobacco use rates and face significant barriers to accessing evidence-based tobacco cessation services. Tobacco quitlines are an effective and accessible resource, yet they are often underutilized. We identify knowledge, practices, and attitudes towards the Texas Tobacco Quitline (TTQL) within behavioral healthcare settings in Texas. Quantitative and qualitative data were collected in 2021 as part of a statewide needs assessment in behavioral healthcare settings. Survey respondents (n = 125) represented 23 Federally Qualified Health Centers, 29 local mental health authorities (LMHAs), 12 substance use treatment programs in LMHAs, and 61 standalone substance use treatment centers (26 people participated in qualitative interviews). Over half of respondents indicated familiarity with the TTQL and believed that the TTQL was helpful for quitting. Qualitative findings reveal potential concerns about inconsistency of services, long wait time, and the format of the quitline. About half of respondents indicated that their center promoted patient referral to TTQL, and few indicated that their center had an electronic referral system with direct TTQL referral capacity. Interview respondents reported overall lack of systematic follow up with patients regarding their use of the TTQL services. Findings suggest the need for (1) increased TTQL service awareness among healthcare providers; (2) further investigation into any changes needed to better serve patients with behavioral health conditions who use tobacco; and (3) electronic health record integration supporting direct referrals and enhanced protocols to support patient follow up after TTQL referral.
Collapse
Affiliation(s)
- Maggie Britton
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Unit 1440, 1400 Pressler Street, Houston, TX 77030, United States
- University of Houston, Department of Psychological, Health, and Learning Sciences, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, United States
- University of Houston, HEALTH Research Institute, 4349 Martin Luther King Blvd, Houston, TX 77204, United States
| | - Anastasia Rogova
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Unit 1440, 1400 Pressler Street, Houston, TX 77030, United States
- University of Houston, Department of Psychological, Health, and Learning Sciences, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, United States
- University of Houston, HEALTH Research Institute, 4349 Martin Luther King Blvd, Houston, TX 77204, United States
| | - Tzuan A. Chen
- University of Houston, Department of Psychological, Health, and Learning Sciences, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, United States
- University of Houston, HEALTH Research Institute, 4349 Martin Luther King Blvd, Houston, TX 77204, United States
| | - Isabel Martinez Leal
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Unit 1440, 1400 Pressler Street, Houston, TX 77030, United States
- University of Houston, Department of Psychological, Health, and Learning Sciences, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, United States
- University of Houston, HEALTH Research Institute, 4349 Martin Luther King Blvd, Houston, TX 77204, United States
| | - Bryce Kyburz
- Integral Care, 1430 Collier St, Austin, TX 78704, United States
| | - Teresa Williams
- Integral Care, 1430 Collier St, Austin, TX 78704, United States
| | - Mayuri Patel
- Texas Department of State Health Services, Tobacco Prevention and Control Branch, 1100 West 49th Street, Mail Code 1965, Austin, TX 78756, United States
| | - Lorraine R. Reitzel
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Unit 1440, 1400 Pressler Street, Houston, TX 77030, United States
- University of Houston, Department of Psychological, Health, and Learning Sciences, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, United States
| |
Collapse
|
3
|
Hunter A, Yargawa J, Notley C, Ussher M, Bobak A, Murray RL, Nath S, Cooper S. Healthcare Professionals' Beliefs, Attitudes, Knowledge, and Behavior Around Vaping in Pregnancy and Postpartum: A Qualitative Study. Nicotine Tob Res 2021; 23:471-478. [PMID: 32621745 PMCID: PMC7885779 DOI: 10.1093/ntr/ntaa126] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/02/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Finding effective ways to help pregnant women quit smoking and maintain long-term abstinence is a public health priority. Electronic cigarettes (ie, vaping) could be a suitable cessation tool in pregnancy for those who struggle to quit; however, healthcare professionals (HCP) must be informed about these devices to offer appropriate advice. This study used the Capability, Opportunity, Motivation, and Behavior (COM-B) model and Theoretical Domains Framework (TDF) to explore HCP attitudes towards vaping in pregnancy and postpartum; beliefs about the health risks of vaping; perceived barriers and facilitators of vaping in pregnancy; knowledge of current guidelines and policies; and training needs. METHODS Interviews (n = 60) were conducted with midwives (n = 17), health visitors (n = 10), general practitioners (n = 15) and stop smoking specialists (n = 18) across the United Kingdom. Interview transcriptions were analyzed thematically using the framework approach and the COM-B. RESULTS Discussing vaping as a tool for quitting smoking in pregnancy was prevented by a lack of capability (limited knowledge of vaping, lack of training in smoking cessation); lack of opportunity (restricted by organizational policies and guidelines, lack of time and financial issues impacting on training), and negative social influences (sensationalist media and stigma associated with vaping in pregnancy); and lack of motivation (fear of future litigation and comebacks should adverse effects from vaping arise). CONCLUSIONS Factors related to capability, opportunity, and motivation were identified that influence HCPs attitudes and behaviors towards vaping in pregnancy. Gaps in knowledge and training needs were identified, which could inform the development of targeted vaping training. IMPLICATIONS Vaping could be suitable in pregnancy for those struggling to quit smoking. However, HCPs must be informed about these devices to offer appropriate advice. These data extend our knowledge of factors influencing HCP attitudes and behaviors towards vaping in pregnancy. Generally, vaping was perceived as safer than cigarettes, but a perceived lack of evidence, health and safety risks, dependency, and regulation issues were concerning. Considering our findings, greater efforts are needed to ensure HCPs are sufficiently informed about vaping and guidelines available. More importance should be placed on training for all HCPs who have contact with pregnant women.
Collapse
Affiliation(s)
- Abby Hunter
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Judith Yargawa
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Caitlin Notley
- Addiction Research Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Michael Ussher
- Institute of Social Marketing and Health, University of Stirling, Stirling and Population Health Research Institute, St George’s, University of London, London, UK
| | - Alex Bobak
- Alex Bobak, GP Specialist in Smoking Cessation, Wandsworth Medical Centre, London, UK
| | - Rachael L Murray
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Srabani Nath
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Sue Cooper
- Division of Primary Care, School of Medicine, University of Nottingham, University Park, Nottingham, UK
| |
Collapse
|
4
|
Smith CA, Shahab L, McNeill A, Jackson SE, Brown J, Brose L. Harm Perceptions of E-cigarettes Among Smokers With and Without Mental Health Conditions in England: A Cross-Sectional Population Survey. Nicotine Tob Res 2021; 23:511-517. [PMID: 31970407 PMCID: PMC7885771 DOI: 10.1093/ntr/ntaa020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/23/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION E-cigarettes (ECs) may benefit smokers with mental health conditions who are more likely to smoke, and smoke more heavily, than those without mental health conditions. This could be undermined if harm misperceptions in this group are high as is the case in the general population. This study aimed to assess EC harm perceptions relative to cigarettes as a function of mental health status and a variety of characteristics. METHODS Data were collected from 6531 current smokers in 2016/2017 in household surveys of representative samples of adults. The associations of mental health status (self-reported mental health condition and past year treatment), smoking and EC use characteristics, and characteristics relating to use of potential information sources with harm perceptions of ECs relative to cigarettes (measured by correct response "less harmful" vs. wrong responses "more harmful," "equally harmful," "don't know") were analyzed with logistic regression. RESULTS A similar proportion of smokers without mental health conditions (61.5%, 95% CI 60.1-62.9) and with mental health conditions (both with [61.3%, 95% confidence interval [CI] 58.7-63.8] and without past year treatment [61.5%, 95% CI 58.1-64.7]) held inaccurate EC harm perceptions (all P > 0.05). Being female, nonwhite, aged 25-34 compared with 16-24, from lower social grades (C2, D, and E), not having post-16 qualifications, no EC experience, a daily smoker, unmotivated to quit <1 month, non-internet user and non-broadsheet reader were all associated with more inaccurate harm perceptions (all p < .05). CONCLUSIONS The majority of smokers in England have inaccurate harm perceptions of ECs regardless of mental health status. IMPLICATIONS This study is the first to use a nationally representative sample in order to investigate whether smokers with and without mental health conditions differ with regard to harm perceptions of ECs. Findings show that the majority of smokers in England hold inaccurate harm perceptions of ECs, and this does not differ as a function of mental health status. A number of characteristics associated with disadvantaged groups were significantly associated with inaccurate harm perceptions. These findings highlight the need to improve awareness and understanding among disadvantaged groups regarding the relative harms of ECs compared with tobacco.
Collapse
Affiliation(s)
- Charlie Albert Smith
- Department of Behavioural Science and Health, University College London, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
| | - Ann McNeill
- National Addiction Centre, King’s College London, London, UK
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
| | - Leonie Brose
- National Addiction Centre, King’s College London, London, UK
| |
Collapse
|
5
|
Caponnetto P, Polosa R. A qualitative study of the views about smoking, licensed cessation aids and e-cigarettes in people with schizophrenia spectrum disorders. J Addict Dis 2020; 39:152-165. [PMID: 33043838 DOI: 10.1080/10550887.2020.1826097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Smoking prevalence remains high among people with a mental health condition compared to those without. Understanding people's motivation to quit and their views of smoking cessation support may help to develop future interventions. We conducted a qualitative study to explore the perceptions of 30 people with schizophrenia spectrum disorders who were current smokers, about smoking traditional cigarettes, the appeal of licensed medicines and e-cigarettes for smoking cessation or smoking reduction. The experiences of participants who were motivated to quit were compared with those who were not motivated to quit. Findings suggest traditional cigarettes were pleasurable and licensed cessation aids and e-cigarettes unappealing to participants who were unmotivated to quit. Whereas nicotine replacement products and e-cigarettes may be an appealing smoking cessation or reduction strategy for those motivated to quit. There is a need to find ways of making traditional cigarettes less appealing and alternative less harmful nicotine products (licensed and unlicensed) more appealing and accessible to this group of high risk smokers.
Collapse
Affiliation(s)
- Pasquale Caponnetto
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK.,Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria Policlinico "G. Rodolico-S. Marco," University of Catania, Catania, Italy.,Department of Educational Sciences, University of Catania, Catania, Italy.,Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, Catania, Italy
| | - Riccardo Polosa
- Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, Catania, Italy.,Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| |
Collapse
|