Huddlestone Lisa, Shoesmith Emily, Pervin Jodi, Stevens Rosie, Gilbody Simon, Ratschen Elena
Department of Health Sciences, University of York, Heslington, York, UK.
Hull York Medical School, University of York, Heslington, York, UK.
Nicotine Tob Res. 2025 May 22;27(6):951-961. doi: 10.1093/ntr/ntae237.
Digital technology is increasingly used to support interventions targeting smoking cessation in people with severe mental illness (SMI). However, little is known about their implementation and effectiveness in this population. We aimed to determine the effectiveness, stakeholder experiences, factors influencing implementation, and quality of reporting of digital interventions for smoking cessation in adults living with SMI.
Five online bibliographic databases were searched for articles published between December 31, 2000 and January 31, 2023. Studies involving adults accessing treatment for alcohol and substance use disorders, neurocognitive disorders, and terminal illnesses were excluded. Risk of bias was assessed using the Mixed Methods Appraisal Tool. A Mantel-Haenszel random-effects meta-analysis of randomized controlled trials was conducted. Participant experience and intervention implementation were explored using a narrative synthesis. Quality of reporting of interventions was assessed using the Template for Intervention Description and Replication checklist.
Thirty-one studies enrolling 3794 participants were included. Meta-analysis of biochemically verified abstinence at longest follow-up (month 1 to month 6) did not find an overall effect in favour of intervention (risk ratio = 0.66, 95% confidence interval = -0.005 to 1.37). Interventions tailored to people with SMI were perceived as acceptable. Implementation strategies concentrated on overcoming practical challenges at the participant/user level.
No evidence of the effectiveness of digital interventions to support smoking cessation in people with SMI was found. The importance of tailoring interventions to the needs of people with SMI is highlighted. Robust reporting of implementation is required to enhance future efforts to support smoking cessation in adults with SMI.
The findings of this review add to the emerging evidence on digital interventions to support smoking cessation among people with SMI. We highlight the importance of tailoring interventions to the population, particularly considering the role of mental illness and the side effects of psychotropic medication in the accessibility and usability of digital interventions.
数字技术越来越多地用于支持针对严重精神疾病（SMI）患者戒烟的干预措施。然而，对于这些措施在该人群中的实施情况和效果知之甚少。我们旨在确定针对患有SMI的成年人的数字戒烟干预措施的效果、利益相关者的经验、影响实施的因素以及报告质量。
检索了五个在线书目数据库，以查找2000年12月31日至2023年1月31日期间发表的文章。排除了涉及接受酒精和物质使用障碍、神经认知障碍及晚期疾病治疗的成年人的研究。使用混合方法评估工具评估偏倚风险。对随机对照试验进行了Mantel-Haenszel随机效应荟萃分析。通过叙述性综合分析探讨了参与者的经验和干预措施的实施情况。使用干预描述与复制模板清单评估干预措施的报告质量。
纳入了31项研究，共3794名参与者。对最长随访期（第1个月至第6个月）经生化验证的戒烟情况进行的荟萃分析未发现干预措施具有总体效果（风险比=0.66，95%置信区间=-0.005至1.37）。针对SMI患者量身定制的干预措施被认为是可以接受的。实施策略集中在克服参与者/用户层面的实际挑战。
未发现数字干预措施对支持SMI患者戒烟有效的证据。强调了根据SMI患者的需求量身定制干预措施的重要性。需要对实施情况进行有力报告，以加强未来支持SMI成年人戒烟的努力。
本综述的结果增加了关于支持SMI患者戒烟的数字干预措施的新证据。我们强调了根据该人群特点量身定制干预措施的重要性，特别是考虑到精神疾病的作用以及精神药物的副作用对数字干预措施可及性和可用性的影响。
