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Introduction: The prevalence of smoking among persons with a mental illness has remained unchanged, being 2-3 times higher than the general population in high-income countries. Assessment of the volume and characteristics of research output over time can assist in identifying research priorities to promote progress within a field. The aim of this study was to undertake such an assessment in the field of smoking and mental illness.Methods: A descriptive repeat cross-sectional study was conducted of peer-reviewed publications in Medline and PsycINFO for the periods 1993-1995, 2003-2005, and 2013-2015. Publications were classified as data- or non-data-based; data-based publications were further categorized by study type, population, setting, and for intervention-focused publications by level of evidence and research translation phase.Results: Included were 547 articles published in 1993-1995 (n = 65), 2003-2005 (n = 153), and 2013-2015 (n = 329). The number and proportion of data-based publications significantly increased over time, although their focus remained predominantly descriptive (≥83%); less than 14% of publications in any period had an intervention focus. The proportion of publications reporting on study populations with multiple diagnostic categories and recruiting from nonmental health settings, significantly increased from 1993-1995 to 2003-2005, however then plateaued by 2013-2015. The level of evidence provided by intervention-focused publications was suggested to increase over time, however there was no evident variation in translation phase.Conclusions: Research has increased over time to characterize smoking among those with a mental illness; however more is needed to inform the development and implementation of effective cessation interventions for this group.Implications: This is the first study to examine the volume and characteristics of research publications in the field of smoking and mental illness over time. The number of publications increased fivefold between 1993-1995 and 2013-2015. Between 1993-1995 and 2003-2005, progression was also indicated by increased: data-based publications, diagnostic diversity of samples, and variation in study settings; however further increases in such measures were not evident in 2013-2015. Notably, it continues to be the case that few intervention studies are undertaken. To achieve meaningful changes in the smoking prevalence of this group, a greater focus on research that assesses the effectiveness and implementation of tailored cessation interventions is required. [ABSTRACT FROM AUTHOR]

The implementation of smoke-free policies in inpatient psychiatric facilities, including patient adherence, mental health nursing staff support, and provision of nicotine-dependence treatment to patients, has been reported to be poor. The extent to which the quality of smoke-free policy implementation is associated with patient views of a policy is unknown. We conducted a cross-sectional survey of 181 patients (53.6%, n = 97 smokers; and 46.4%, n = 84 non-smokers) in an Australian inpatient psychiatric facility with a total smoke-free policy. Smokers' adherence to the policy was poor (83.5% smoked). Only half (53.6%) perceived staff to be supportive of the policy. Most smokers used nicotine-replacement therapy (75.3%); although few received optimal nicotine-dependence treatment (19.6%). Overall, 45.9% of patients viewed the smoke-free policy in the unit as positive (29.9% smokers; 64.3% non-smokers). For smokers, adhering to the ban, perceiving staff to be supportive, and reporting that the nicotine-replacement therapy reduced cravings to smoke were associated with a more positive view towards the smoke-free policy. These findings support the importance of patient adherence, mental health nursing staff support, and adequate provision of nicotine-dependence treatment in strengthening smoke-free policy implementation in inpatient psychiatric settings. [ABSTRACT FROM AUTHOR]

Objective: Amongst people with a mental illness, modifiable health risk behaviours contribute substantially to increased chronic disease morbidity and mortality. This study examined the prevalence of and interest in changing such behaviours amongst community mental health service clients in Australia. Method: A telephone interview was undertaken with Australian community mental health service clients. Participants reported engagement in four health risk behaviours: tobacco smoking, fruit and vegetable consumption, alcohol consumption, and physical activity. Participants were classified as at risk based upon Australian national guidelines. At-risk participants were asked whether they were considering improving their health risk behaviour within the next month. The association between psychiatric diagnosis and risk, and interest in improving health risk behaviours was examined. Results: Risk prevalence was highest for inadequate vegetable consumption (78.3%), followed by inadequate fruit consumption (60%), smoking (50.7%), physical inactivity (46.8%), short-term alcohol risk (40.3%) and chronic alcohol risk (35.3%). A majority of at-risk participants were considering improving their health risk behaviour for smoking, physical inactivity and inadequate fruit and vegetable consumption (65.1%, 71.1%, and 53.3%, respectively). After adjusting for demographic factors, no diagnostic categories were associated with risk for any behaviour. Those with a diagnosis of depression were more likely to be interested in quitting smoking and increasing physical activity. Conclusions: Regardless of diagnosis, a high prevalence of chronic disease health risk behaviours was identified, with many participants expressing an interest in improving these behaviours. Such findings reinforce recommendations that preventive care addressing the chronic disease risks of clients be provided routinely by mental health clinicians. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000693729. URL: www.anzctr.org.au/ [ABSTRACT FROM AUTHOR]

Background: Family carers provide significant support to people with a mental illness; yet may experience poor mental and physical health themselves. Among limited research addressing the physical health of carers, studies of carers of people with dementia and young people with psychosis suggest increased risk of chronic diseases in conjunction with higher levels of potentially modifiable lifestyle risk behaviours. This exploratory study, conducted with carers of people with various mental illnesses, aimed to determine: carer prevalence of health risk behaviours (inadequate fruit and vegetable consumption, inadequate physical activity, harmful alcohol consumption, and tobacco smoking); interest in changing 'at risk' behaviours; and potential associations of socio-demographic characteristics with risk status and interest in change.Methods: A cross-sectional survey was conducted among family carers of people with a mental illness (N = 144) residing in New South Wales, Australia. Analyses explored risk behaviour prevalence and interest in change, and associations with socio-demographic variables.Results: Inadequate fruit and vegetable consumption was most prevalent (74.8%), followed by engaging in inadequate amounts of physical activity (57.6%); harmful alcohol consumption (36.3%) and smoking (11.8%). The majority of carers were interested in improving 'at risk' behaviours (56.3-89.2%), with the exception of alcohol consumption (41.5%). Previously or never married participants were more likely to consume inadequate amounts of fruits and/or vegetables compared to those married or cohabiting (Odds Ratio [OR]: 4.1, 95% Confidence Interval [CI]: 1.3-12.9, p = .02). Carers in the workforce were more likely to be engaging in inadequate physical activity (OR: 2.6, 95% CI: 1.2-5.7, p =  .02); and male participants were more likely to engage in harmful alcohol consumption (OR: 2.9, 95% CI: 1.1-7.9, p = .03). Working carers were approximately five times more likely to report interest in improving their alcohol consumption (OR: 5.1, 95% CI: 1.3-20.5, p = .02) compared to those not currently in the workforce.Conclusions: Results suggest high engagement in health risk behaviours among carers of people with a mental illness, particularly with regards to harmful alcohol consumption. Findings suggest a need to develop and implement chronic disease prevention strategies. Further research with larger representative samples is needed to confirm findings. [ABSTRACT FROM AUTHOR]