Systemic factors that perpetuate smoking among community and institutionalised public mental health service populations

Abstract

Despite a vast body of research on smoking, quit rates for people with a concurrent mental illness remain extremely low. Research has established that these groups smoke more heavily, for more years and in greater proportions than the general population - up to 90% compared with 25% respectively. This thesis reports on the findings of a study investigating the barriers to quitting among community-based and institutionalised psychiatric populations. Participants were drawn from the four diagnostic categories of schizophrenia, bipolar affective disorder, major depression and borderline personality disorder. Interviews were performed with smokers from each diagnostic group as well as with clients who had successfully quit smoking. Multi-disciplinary staff from community and inpatient mental health services were also interviewed. Participant observation of inpatient settings and community hostels completed the triangulation of method.