Lum Alistair, Skelton Eliza, Wynne Olivia, Bonevski Billie
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
Front Psychiatry. 2018 Nov 6;9:565. doi: 10.3389/fpsyt.2018.00565. eCollection 2018.
People living with schizophrenia are less likely to quit smoking compared with the general population and people living with other psychiatric disorders. Understanding the schizophrenia-specific psychosocial barriers and facilitators to smoking cessation is important for designing effective smoking cessation interventions. We aimed to systematically review research examining psychosocial barriers and facilitators to smoking cessation in people living with schizophrenia. We followed the PRISMA statement to conduct a systematic literature review examining psychosocial barriers and facilitators to smoking cessation in people living with schizophrenia. We searched EMBASE, Medline, PsycINFO, and CINAHL databases from inception to 14 June 2018 to identify relevant articles. We included peer-reviewed original research articles that examined psychosocial barriers and facilitators to smoking cessation, as well as factors associated with maintenance of smoking habits in people living with schizophrenia spectrum disorders. Qualitative, quantitative, or mixed-methods study designs were included. Three authors screened titles, abstracts, and full-texts using the eligibility criteria. We conducted a narrative synthesis of the data to account for the heterogeneity of study designs. We analyzed qualitative and quantitative studies separately. We identified 685 studies from our systematic search and screened the full-text of 134 articles. The final set of 23 articles included 20 quantitative studies and 3 qualitative studies. The most commonly cited barrier to smoking cessation in people living with schizophrenia was cravings and addiction, followed by a perceived increased risk of negative affect associated with quitting smoking. People living with schizophrenia reported smoking to manage stress and to maintain social relationships. People living with schizophrenia were found to be less likely to receive cessation support from health professionals than smokers without schizophrenia. Health concerns were the most commonly mentioned facilitator to quit smoking. People living with schizophrenia experience a wide range of barriers to smoking cessation. The influence of these barriers on smoking cessation likelihood may be greater among people living with schizophrenia than people without psychiatric disorders. Health professionals play an important role in smoking cessation for people living with schizophrenia and should consider barriers and facilitators identified in this review to support quitting in this vulnerable population.
与普通人群及患有其他精神疾病的人相比，精神分裂症患者戒烟的可能性更小。了解精神分裂症患者特有的戒烟心理社会障碍和促进因素，对于设计有效的戒烟干预措施至关重要。我们旨在系统回顾研究精神分裂症患者戒烟的心理社会障碍和促进因素的相关研究。我们遵循PRISMA声明，对精神分裂症患者戒烟的心理社会障碍和促进因素进行系统的文献综述。我们检索了EMBASE、Medline、PsycINFO和CINAHL数据库，检索时间从数据库创建至2018年6月14日，以识别相关文章。我们纳入了经过同行评审的原创研究文章，这些文章研究了精神分裂症患者戒烟的心理社会障碍和促进因素，以及与精神分裂症谱系障碍患者维持吸烟习惯相关的因素。纳入了定性、定量或混合方法的研究设计。三位作者使用纳入标准筛选标题、摘要和全文。我们对数据进行了叙述性综合分析，以解释研究设计的异质性。我们分别分析了定性和定量研究。我们通过系统检索识别出685项研究，并筛选了134篇文章的全文。最终纳入的23篇文章包括20项定量研究和3项定性研究。精神分裂症患者最常被提及的戒烟障碍是渴望和成瘾，其次是认为戒烟会增加负面影响的风险。精神分裂症患者报告称吸烟是为了应对压力和维持社会关系。与没有精神分裂症的吸烟者相比，发现精神分裂症患者从健康专业人员那里获得戒烟支持的可能性更小。健康问题是最常被提及的戒烟促进因素。精神分裂症患者在戒烟方面面临广泛的障碍。这些障碍对精神分裂症患者戒烟可能性的影响可能比对没有精神疾病的人更大。健康专业人员在精神分裂症患者戒烟中发挥着重要作用，应考虑本综述中确定的障碍和促进因素，以支持这一弱势群体戒烟。
