The Croft smoking cessation programme

The Croft is a Day service providing social groups, activity groups, drop-in, training, and access to education for people with severe mental illness.

For a number of years, the local PCT has run a smoking cessation programme at the Croft once a year.

The smoking cessation programme at the Croft was developed from the governments Fresh Start programme, which is PCT & Valley funded.  It was originally developed by a psychologist who devised a programme that focused on the habitual aspects of the smoker, but more specifically tailored to people with severe mental illness who may have additional needs to those provided by traditional smoking cessation programmes.  Freshstart wasn’t working for this particular group because the ‘sessions’ tended to be at night and there was no additional support offered to this particular client group.  When the Croft approached Freshstart originally to develop a programme to take place at the Croft to address this issue, it was initially met with resistance.  However, pressure form the Croft and a particular cessation worker eventually led to a programme being set up at the Croft.  It began in January 2003 with 14 service users.  The Programme was designed with a Rethink Team Leader at the Croft who had been through a smoking cessation programme herself, and a cessation worker. 

How does it work?
Smoking cessation workers are medically trained to help smokers.  This particular programme was developed in response to a need for specific programme for people with smi. Practical support is offered throughout the programme by the Croft. 

There is an awareness among staff of specific issues that are pertinent to people with severe mental illness. For example, advice must be sensitive not to appear coercive. Certain medication (eg Clozapine) can be affected when a person stops smoking.People with diabetes can also be affected in particular ways as blood sugar levels are affected by smoking – thus GPs must be informed of any plan to quit smoking.

The programme begins with being given a ‘quit date’ to achieve.  Before this date, participants are given 4 weeks psychological support.  This is aimed at breaking down the habitual pattern specific to the individual smoker.  An example of this is if person is used to eating a meal and then sitting in a seat to watch a particular programme and smoke, it is suggested that they move to another seat.

As part of the process, the most suitable method of quitting is decided between service user and cessation worker (inhaler, patches, chewing gum).  Zyban is available on prescription as aid to smoking cessation, but cannot be taken by people on antipsychotics.  A Large proportion of service users go for the patch method.  The level of risk to individuals with severe mental illness from using patches is the same as in the general population (some people may have an allergy to the ingredients). 

Each client is followed up 10 weeks after their quit date.

What support is offered? 

  • Contact continues throughout the programme and after ad inifinitum if needed, with the Team Leader at the Croft and the cessation worker, if the person needs support or assurance. 
  • Many service users are assigned a ‘buddy’ to offer mutual support through the process.

What are the results?

  • The success rate with this Croft programme is higher than the national rate
  • Approximately 10-15 people per year give up through the programme 
  • The total number so far is approximately 60.

One service user went through the Fresh Start programme 6 times and was unable to give up. He then went through the Croft and managed to quit smoking the first time on the programme.