Use of evidence based smoking cessation interventions in community mental health centers

Background: Guidelines strongly recommend that smokers with mental illness receive the same evidence-based practice as smokers in the general population. The goal of this cross-sectional study was to evaluate the resources, barriers and willingness to implement evidence based smoking cessation interventions among clinicians working in community mental health centers. Methods: All eligible clinicians at 9 community mental health centers (5 psychosocial rehabilitation programs and 4 community mental health clinics) in 4 counties in Maryland were surveyed. The questionnaire evaluated availability, barriers, and utilization of evidenced based smoking cessation counseling including willingness to use evidenced based practices (assessed by the evidenced base practice assessment scale-15 (EBPAS-15)). Results: Of the sample (n=95), most were non-smoking (62.8%), full time employees (84.2%), with masters degrees (55.7%), who had over 10 years experience in mental health field. Less than half reported asking about smoking status. Less than a third advised or assisted in smoking cessation. Only one in twenty reported being very confident in their ability to provide smoking cessation counseling and most reported that smoking cessation may worsen psychiatric symptoms (66%).Barriers to providing smoking cessation counseling included believing patients aren't interested in quitting (76.6%), and lack of affordability of various smoking cessation treatments(>60%). On average, clinicians reported it would be appealing to use evidenced based smoking cessation interventions if they received appropriate training (EBPAS 15: mean(SD): 3.14 (0.79)). Implications: Mental health clinicians rarely provide evidenced based smoking cessation interventions to their patients that smoke. Barriers appear to be modifiable through training and education.