Background:
Concerns about withdrawal effects and worsening of mental health conditions are barriers to proposing smoking cessation to psychiatric patients.

Methods:
The study included 156 smokers who attended public psychiatric services and participated in a motivational intervention that included a 26-hour tobacco abstinence period and other components*. Carbon monoxide levels and withdrawal symptoms (MNWS) were evaluated at pre- (3 days before), during (9 hr and 26 hr abstinence) and post-intervention (7 days after).

Results:
Irritability, anxiety, depressed mood and concentration difficulties significantly decreased during the intervention (pre- and 26 hr comparison), both for patients who did and did not succeed with smoking abstinence. Whereas craving decreased for those who succeeded, it remained elevated for those not succeeding.



[MNWS scores (0-4)]



Conclusions:
Results are at odds with usual observations of increased discomfort associated with smoke deprivation and suggest that mental health patients may tolerate short abstinence periods, without worsening of their mental health condition. Although not systematically observed, craving may remain an obstacle for a subgroup of patients. We hypothesize that behavioural associations, habits and environmental factors could be more important obstacles when stopping smoking than usual withdrawal effects.
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*Keizer, I., Gex-Fabry, M., Croquette, P. and Khan, A. N. (2016). A Short Motivational Program Based on Temporary Smoking Abstinence: Towards Increased Self-Efficacy to Quit in Psychiatric Inpatients. Journal of Addiction Research & Therapy, 7:4.