Open Access Open Badges Study protocol

Evaluating the efficacy of an integrated smoking cessation intervention for mental health patients: study protocol for a randomised controlled trial

Alexandra P Metse1*, Jenny A Bowman12, Paula Wye13, Emily Stockings12, Maree Adams1, Richard Clancy14, Margarett Terry5, Luke Wolfenden13, Megan Freund13, John Allan6, Judith J Prochaska7 and John Wiggers123

Author Affiliations

1 University of Newcastle, University Drive, Callaghan, NSW 2308, Australia

2 Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia

3 Hunter New England Population Health, Longworth Ave, Wallsend, NSW 2287, Australia

4 Centre for Translational Neuroscience and Mental Health, Mater Hospital, Cnr Edith and Platt Streets, Waratah, NSW 2298, Australia

5 Mental Health and Substance Use Service, Mater Hospital, Cnr Edith and Platt Streets, Waratah, NSW 2298, Australia

6 Mental Health and Drug and Alcohol Office, NSW Department of Health, 73 Miller Street, North Sydney, NSW 2060, Australia

7 Stanford Prevention Research Centre, Medical School Office Building, 1265 Welch Road, Mail Code 5411, Stanford, CA 94305-5411, USA

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Trials 2014, 15:266  doi:10.1186/1745-6215-15-266

Published: 5 July 2014



Smoking rates, and associated negative health outcomes, are disproportionately high among people with mental illness compared to the general population. Smoke-free policies within mental health hospitals can positively impact on patients’ motivation and self-efficacy to address their smoking. However, without post-discharge support, preadmission smoking behaviours typically resume. This protocol describes a randomised controlled trial that aims to assess the efficacy of linking mental health inpatients to community-based smoking cessation supports upon discharge as a means of reducing smoking prevalence.


Eight hundred participants with acute mental illness will be recruited into the randomised controlled trial whilst inpatients at one of four psychiatric inpatient facilities in the state of New South Wales, Australia. After completing a baseline interview, participants will be randomly allocated to receive either: ‘Supported Care’, a multimodal smoking cessation intervention; or ‘Normal Care’, consisting of existing hospital care only. The ‘Supported Care’ intervention will consist of a brief motivational interview and a package of self-help material for abstaining from smoking whilst in hospital, and, following discharge, 16 weeks of motivational telephone-based counselling, 12 weeks of free nicotine replacement therapy, and a referral to the Quitline. Data will be collected at 1, 6 and 12 months post-discharge via computer-assisted telephone interview. The primary outcomes are abstinence from smoking (7-day point prevalence and prolonged cessation), and secondary outcomes comprise daily cigarette consumption, nicotine dependence, quit attempts, and readiness to change smoking behaviour.


If shown to be effective, the study will provide evidence in support of systemic changes in the provision of smoking cessation care to patients following discharge from psychiatric inpatient facilities.

Trial registration

Australian New Zealand Clinical Trials Registry ANZTCN: ACTRN12612001042831. Date registered: 28 September 2012.

Smoking cessation; Mental illness; Inpatient; Community; Multimodal intervention