They’re Going to Smoke Anyway’

A Qualitative Study of Community Mental Health Staff and Consumer Perspectives on the Role of Social and Living Environments in Tobacco Use and Cessation

Bibliographic Data

ID15522784
AuthorsLaura Twyman (0000-0003-2255-9086, University of Newcastle Australia, corresponding author), Carla Cowles, Scott Walsberger (Cancer Council NSW), Scott C Walsberger, Amanda L Baker, Amanda Baker (0000-0001-5806-4419, University of Newcastle Australia), Billie Bonevski (0000-0001-8505-622X, University of Newcastle Australia)
Year2019
Volume10
Pages503-503
Publication date2019-07-17
Open AccessYes
TypeARTICLE
VenueFrontiers in Psychiatry (JOURNAL)
Journal identifiersISSN: 1664-0640 • E-ISSN: 1664-0640
PublisherFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2019.00503
PMID31379622
OpenAlexW2977972631
LanguageEN
Citations received3
References cited57

Background: Addressing the high prevalence of tobacco use experienced by people with severe mental illness (SMI) requires consideration of the influence of wider cultural, socioeconomic and environmental factors. This qualitative study aimed to examine the impact of social and living environments on tobacco use and cessation by people with SMI accessing community managed mental health services. The perspectives of both staff and consumers with SMI were explored. Methods: Semi-structured focus groups were undertaken with a purposive sample of community mental health staff and consumers from three sites in three major cities in NSW, Australia. Two sites provided outreach support, and one site provided residential support. Data were collected (2017-2018) until saturation was reached. Focus groups were audio-recorded and transcribed, and thematic analysis was conducted. Results: Thirty-one staff and 17 consumers participated separately in six focus groups. Themes identified by staff included a degree of fatalism, conceptualising tobacco use as choice rather than addiction and tensions between cessation support and broader models of care. Staff viewed smoke-free home and mental health service policies as effective at promoting quitting but contradictory to recovery-oriented models of care. Consumers identified smoking as an integral part of life and social networks, as a way of maintaining control and lack of social support to quit as key themes. While many consumers reported smoking inside the home, others described enforcing smoke-free rules. Conclusion: Social and living environments played an integral role in tobacco use and cessation for both staff and consumers. The role of community managed mental health organisations in addressing tobacco use within social and living environments was not strongly supported by staff and sometimes seen as antithetical to recovery-oriented models of care. Potential ways to address this include education and training for prospective and current community mental health organisation staff highlighting the synergy between the recovery-oriented model and provision of preventive health support

Environmental health · Mental health · Political science · Psychiatry · Public relations · Qualitative research · Smoking cessation · Sociology · Tobacco use · Health, psychology, and well-being · Medicine · Psychology · Smoking Behavior and Cessation · Substance Abuse Treatment and Outcomes

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