The group consist of the CRUK, Royal College of Psychiatrists, ASH UK, Fresh, UKTAS, the Royal College of General Practitioners, Rethink, the University of York, the College of Mental Health Pharmacy, Breath, the Association of Mental Health Providers, and the National Centre for Smoking Cessation and Training.
The joint statement lays out that people with mental health conditions are almost twice as likely to smoke, that these smokers struggle to give up, and quit rates have flatlined. Smoking is a major contributory factor in this group of people dying earlier than the general population, 10 to 20 years earlier.
Professor Ann McNeill is the co-chair of the partnership, and said: “This is a great inequality leading to early death and years of chronic illness for many. E-cigarettes provide a new opportunity for people to move away from smoking and avoid the terrible burden of death and disease it causes.”
A webinar examining implementation of smokefree policies in mental health settings
Alyssa Best, Cancer Research UK: “E-cigarettes offer another opportunity for smokers with mental health conditions that haven’t been able to stop using other methods. They should be offered as a legitimate method of quitting across all mental health settings."
The Group’s Principles for Health Professionals and Support Staff:
- Effective smoking cessation services and harm reduction support for people who smoke are vitally important to public health, and people with mental health conditions have an equal right of access to such services.
- Smoking remains part of the culture in too many mental health settings, making cessation more difficult. Smokefree policies are a vital means of changing this culture and can be implemented successfully with the right leadership and support for patients and staff. Training for staff is essential for them to effectively support patients to quit or abstain from smoking.
- Information on use of NRT, varenicline, bupropion and electronic cigarettes should form part of the care package for people with mental health conditions who smoke. Advice should be based on objective evidence of relative harm: it is better for health to use electronic cigarettes rather than smoke tobacco, and this advice should be given to smokers who find other aids to quitting unsatisfactory. Electronic cigarettes can also be used alongside other treatment options (NRT, varenicline, bupropion) for those who need additional support.
- Vaping is different to smoking. Electronic cigarette use does not meet either the legal or clinical definition of smoking. It is therefore a matter for employers (in partnership with their employees), managers and commissioners of health services to determine whether and where to permit electronic cigarette use in enclosed public places, including in-patient facilities for people with mental health conditions. It is also a matter for employers, managers and commissioners to determine whether to permit electronic cigarette use in grounds attached to such premises. There is no current evidence that secondary vapour from electronic cigarettes is a significant risk to non-users.
- To help smokers to stop smoking and stay smokefree, a more enabling approach to vaping should be considered to make it an easier choice than smoking. Vapers should not be required to use the same space as smokers, as this could undermine their ability to quit and stay smokefree.
- Policies on electronic cigarette use in medical and health premises should be clearly set out and communicated to all patients, staff and visitors. If possible this information should be provided in advance of any inpatient stays.
- Where mental health service providers operate retail outlets, they should consider making NRT and electronic cigarettes available for sale to support accessibility.
- Appropriate hazard waste disposal systems should be established for safe disposal of e-cigarettes, in line with existing policies for other products such as batteries or electronics.