Interventions are required to redress the disproportionate tobacco-related health burden experienced by persons with a mental illness. This study aimed to assess the efficacy of a universal smoking cessation intervention initiated within an acute psychiatric inpatient setting and continued post-discharge in reducing smoking prevalence and increasing quitting behaviours.A randomised controlled trial was undertaken across four psychiatric inpatient facilities in Australia. Participants ( N?=?754) were randomised to receive either usual care ( n?=?375) or an intervention comprising a brief motivational interview and self-help material while in hospital, followed by a 4-month pharmacological and psychosocial intervention ( n?=?379) upon discharge. Primary outcomes assessed at 6 and 12?months post-discharge were 7-day point prevalence and 1-month prolonged smoking abstinence. A number of secondary smoking-related outcomes were also assessed. Subgroup analyses were conducted based on psychiatric diagnosis, baseline readiness to quit and nicotine dependence.Seven-day point prevalence abstinence was higher for intervention participants (15.8%) than controls (9.3%) at 6?months post-discharge (odds ratio?=?1.07, p?=?0.04), but not at 12?months (13.4% and 10.0%, respectively; odds ratio?=?1.03, p?=?0.25). Significant intervention effects were not found on measures of prolonged abstinence at either 6 or 12?months post-discharge. Differential intervention effects for the primary outcomes were not detected for any subgroups. At both 6 and 12?months post-discharge, intervention group participants were significantly more likely to smoke fewer cigarettes per day, have reduced cigarette consumption by ?50% and to have made at least one quit attempt, relative to controls.Universal smoking cessation treatment initiated in inpatient psychiatry and continued post-discharge was efficacious in increasing 7-day point prevalence smoking cessation rates and related quitting behaviours at 6?months post-discharge, with sustained effects on quitting behaviour at 12?months. Further research is required to identify strategies for achieving longer term smoking cessation.
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