Department of Health Sciences, University of York, York, UK.
Centre for Behaviour Change, University College London, London, UK.
Nicotine Tob Res. 2022 Jun 15;24(7):945-954. doi: 10.1093/ntr/ntac004.
Evidence-based smoking cessation and temporary abstinence interventions to address smoking in mental health settings are available, but the impact of these interventions is limited.
We aimed to identify and synthesize the perceived barriers and enablers to supporting smoking cessation in mental health settings. Six databases were searched for articles reporting the investigation of perceived barriers and enablers to supporting smoking cessation in mental health settings. Data were extracted and coded using a mixed inductive/deductive method to the theoretical domains framework, key barriers and enablers were identified through the combining of coding frequency, elaboration, and expressed importance.
Of 31 included articles, 56 barriers/enablers were reported from the perspectives of mental healthcare professionals (MHPs), 48 from patient perspectives, 21 from mixed perspectives, and 0 from relatives/carers. Barriers to supporting smoking cessation or temporary abstinence in mental health settings mainly fell within the domains: environmental context and resources (eg, MHPs lack of time); knowledge (eg, interactions around smoking that did occur were ill informed); social influences (eg, smoking norms within social network); and intentions (eg, MHPs lack positive intentions to deliver support). Enablers mainly fell within the domains: environmental context and resources (eg, use of appropriate support materials) and social influences (eg, pro-quitting social norms).
The importance of overcoming competing demands on staff time and resources, the inclusion of tailored, personalized support, the exploitation of patients wider social support networks, and enhancing knowledge and awareness around the benefits smoking cessation is highlighted.
Identified barriers and enablers represent targets for future interventions to improve the support of smoking cessation in mental health settings. Future research needs to examine the perceptions of the carers and family/friends of patients in relation to the smoking behavior change support delivered to patients.
有循证戒烟和临时戒断干预措施可用于解决心理健康环境中的吸烟问题，但这些干预措施的效果有限。
我们旨在确定和综合支持心理健康环境中戒烟的感知障碍和促进因素。在六个数据库中搜索了报告调查支持心理健康环境中戒烟的感知障碍和促进因素的文章。使用混合归纳/演绎方法对理论领域框架进行数据提取和编码，通过编码频率、详细程度和表达的重要性，确定关键障碍和促进因素。
在 31 篇纳入的文章中，从心理健康保健专业人员（MHPs）的角度报告了 56 个障碍/促进因素，从患者的角度报告了 48 个，从混合角度报告了 21 个，从亲属/照顾者的角度报告了 0 个。支持心理健康环境中戒烟或临时戒断的障碍主要属于以下领域：环境背景和资源（例如，MHPs 缺乏时间）；知识（例如，关于吸烟的互动信息不足）；社会影响（例如，社交网络中的吸烟规范）；和意图（例如，MHPs缺乏提供支持的积极意图）。促进因素主要属于以下领域：环境背景和资源（例如，使用适当的支持材料）和社会影响（例如，促进戒烟的社会规范）。
强调了克服员工时间和资源竞争需求的重要性，包括量身定制、个性化的支持，利用患者更广泛的社会支持网络，以及增强对戒烟益处的了解和认识。
确定的障碍和促进因素代表了未来改善心理健康环境中戒烟支持的干预措施的目标。未来的研究需要检查患者的照顾者和家庭/朋友对患者接受的戒烟行为改变支持的看法。
