Intervention for tobacco dependence among people with a psychotic illness

精神病患者，特别是精神分裂症患者的吸烟率高于一般人群。暴露于烟草烟雾已被确定为32种不同疾病的原因以及火灾的原因。众所周知，烟草烟雾含有致癌物质，以及尼古丁和许多其他有毒物质。大量的科学证据表明，主动吸烟会增加患多种癌症的风险。吸烟相关疾病的发病率仅次于自杀，是精神分裂症早期死亡率的最大贡献者。普遍的看法认为，精神病患者由于精神疾病的影响而缺乏改变行为的动力。然而，最近一项对新南威尔士州纽卡斯尔一家精神病医院住院病人的调查显示，超过四分之一的吸烟者要么准备戒烟，要么减少吸烟，要么已经采取行动减少吸烟。目前的研究提案代表了第一个对精神疾病患者烟草依赖进行干预的大型随机对照试验。这项研究将比较尼古丁替代疗法结合辅导和自助吸烟小册子的效果。这项拟议的研究是在一项关于干预可行性的小型临床研究和一项由澳大利亚扶轮社健康研究基金支持的小型随机对照试验之后进行的。这项拟议的研究汇集了澳大利亚各地几位在治疗精神疾病和药物依赖（包括烟草依赖）患者方面有经验的人的专业知识。研究结果将为未来对患有精神疾病的吸烟者的临床干预提供信息。

The prevalence of smoking among people with a psychiatric illness, especially schizophrenia, is greater than that in the general population. Exposure to tobacco smoke has been identified as a cause of 32 different diseases as well as a cause of fire injuries. Tobacco smoke is known to contain carcinogens, as well as nicotine and numerous other poisonous substances. An extensive body of scientific evidence shows that active cigarette smoking increases the risk of many different cancers. Smoking related diseases rate second in frequency to suicide as the greatest contributor to early mortality in schizophrenia. Popular opinion holds that people with mental illness are lacking in motivation to change their behaviour due to the effects of their mental illness. However, a recent survey of inpatients in a psychiatric hospital in Newcastle, NSW, revealed that over a quarter of smokers were either preparing to quit or cut down on their smoking or already had taken action to reduce their smoking. The present research proposal represents the first large randomised controlled trial of an intervention for tobacco dependence among people with a mental illness. This project will compare the effectiveness of nicotine replacement therapy combined with counselling with a self-help booklet on smoking. The proposed research follows a small clinical study of the feasibility of the intervention and a small randomised controlled trial supported by the Australian Rotary Health Research Fund. The proposed study brings together the expertise of several people across Australia who have experience in treating people with mental illness and drug dependence, including tobacco dependence. The results will inform future clinical interventions for smokers with a mental illness.