The SCIMITAR programme
We developed a bespoke smoking cessation intervention (BSC) to help people with serious mental ill health (SMI) cut down or quit smoking.
The problem
People with SMI problems such as schizophrenia or bipolar disorder are three to four times more likely to smoke than people in the general population. Smoking contributes to poor health, poverty and early death in people with SMI, who on average die 20 to 25 years earlier than those without.
Smoking makes a significant contribution to this health inequality. Whilst smoking rates are falling in the general population, they have remained unchanged among people who use mental health services. For these reasons, it is clear that conventional approaches to smoking cessation might need to be tailored to people with SMI.
The trial
The team developed a bespoke smoking cessation intervention to help people with SMI cut down or quit smoking. This intervention was tested in the SCIMITAR pilot trial which successfully recruited and followed up 97 participants and found that the BSC intervention was acceptable to people with SMI.
Following the pilot trial the SCIMITAR+ trial was conducted to evaluate the clinical effectiveness and the cost effectiveness of the SCIMITAR intervention. The SCIMITAR+ trial recruited 526 people who were randomly allocated to either the BSC intervention or usual smoking cessation services.
The SCIMITAR+ trial found that after six months, participants who received the bespoke intervention were twice as likely to have quit smoking than those who received usual care. The difference was still evident at 12 months, in a combined analysis of pilot and full trial data. The analysis gives the greatest level of statistical power to examine long term quit rates, which are important for individuals, policy makers and mental health services.
This project commenced on 01/01/2015 and was funded by the NIHR HTA.
SCIMITAR pilot trial
- Bespoke smoking cessation for people with severe mental ill health (SCIMITAR): a pilot randomised controlled trial
- Smoking Cessation Intervention for severe Mental Ill Health Trial (SCIMITAR): a pilot randomised control trial of the clinical effectiveness and cost-effectiveness of a bespoke smoking cessation service
- Smoking cessation in severe mental illness: what works?
- Helping people with serious mental illness to cut down or stop smoking
- Exploring why people with SMI smoke and why they may want to quit: baseline data from the SCIMITAR RCT
- Making the journey with me: a qualitative study of experiences of a bespoke mental health smoking cessation intervention for service users with serious mental illness
SCIMITAR+ trial
- Smoking Cessation Intervention for Severe Mental Ill Health Trial (SCIMITAR+): study protocol for a randomised controlled trial
- Smoking cessation in severe mental illness: combined long-term quit rates from the UK SCIMITAR trials programme
- Smoking cessation for people with severe mental illness (SCIMITAR+): a pragmatic randomised controlled trial
- Smoking cessation in severe mental ill health: what works? an updated systematic review and meta-analysis
- Successful recruitment to trials: findings from the SCIMITAR+ Trial
- Standard smoking cessation services in sites participating in the SCIMITAR+ trial for people with severe mental ill health
Our partners
- 2Gether, NHS Foundation Trust
- Berkshire Healthcare, NHS Foundation Trust
- Bradford District Care, NHS Foundation Trust
- Cambridge and Peterborough, NHS Foundation Trust
- Camden and Islington, NHS Foundation Trust
- Greater Manchester Mental Health, NHS Foundation Trust
- Kent and Medway NHS and Social Care, NHS Foundation Trust
- Lancashire Care, NHS Foundation Trust
- Leeds and York Partnership, NHS Foundation Trust
- Lincolnshire Partnership, NHS Foundation Trust
- Northumberland Tyne and Wear, NHS Foundation Trust
- Oxford Health, NHS Foundation Trust
- Rotherham, Doncaster and South Humberm NHS Foundation Trust
- Sheffield Health and Social Care, NHS Foundation Trust
- Solent, NHS Trust
- Somerset Partnership, NHS Foundation Trust
- South West Yorkshire Partnership, NHS Foundation Trust
- Southern Health, NHS Foundation Trust
- Sussex Partnership, NHS Foundation Trust
- Tees, Esk and Wear Valleys, NHS Foundation Trust