1 in 4 smokers has a mental health condition but doctors and nurses not getting the training they need to help

16 December 2020

A new report published today by Action on Smoking and Health (ASH) [1] has found the current training of mental health nurses and psychiatrists to help their patients quit smoking is woefully inadequate and risks leaving people behind as the Government commits to delivering a smokefree nation by 2030 [2].

The report comes as new analysis finds that there are 1.6 million smokers in England with a long term mental health condition equivalent to 1 in 4 of all smokers [3]. The very high rates of smoking among people with poor mental health is a major source of early death and disease and a leading cause of the 15-20 year gap in life expectancy [4] with the rest of the population.

A majority of doctors and nurses felt their training and education had ill-equipped them to support their patients. They supported training being mandatory throughout a professional’s career, starting at undergraduate level.

Dr Adrian James, President of the Royal College of Psychiatrists said:
said:

"Psychiatrists are passionate about helping their patients live healthier lives. This report shows that gaps in training are undermining progress. Smoking is not an inevitable part of our patient’s lives but an addiction to treat. Improving the skills and knowledge of psychiatrists is a vital step in the right direction.”

Professor Dame Anne Marie Rafferty, President of Royal College of Nursing said:

“Our patients need us to provide effective support for an addiction that is killing them. That doesn’t mean every mental health nurse needs to become an expert, but we must be able to talk to people about their smoking in a meaningful way and discuss the options out there to help them quit. With better training the goal of a smokefree future for our patients is much more achievable.”

The report calls for a national plan to roll out training on smoking for mental health staff, to ensure they are equipped to help their patients quit. Such training is effective and cost-effective, and is essential if the NHS is to deliver on its commitment to providing universal stop smoking service offer for people in mental health services.[5],

Hazel Cheeseman, Director of Policy, ASH said:

“Smoking in mental health services needs to be taken as seriously as alcohol and illicit drug addictions. Many thousands of people with mental health conditions die from smoking every year and this will continue unless there is adequate investment in staff training.”

“If the Government is serious in its desire to level up society and deliver a smokefree nation by 2030 doctors and nurses must be trained to can give smokers with mental health conditions the help they need to quit.”

References
[1] Action on Smoking and Health. Smokefree Skills: Training needs of mental health nurses and psychiatrists. December 2020. Executive Summary: https://ash.org.uk/wp-content/uploads/2020/12/ExecSummary_MHTraining_F.pdf. Full Report: https://ash.org.uk/wp-content/uploads/2020/12/MHTraining_FullReport.pdf

[2] Jo Churchill MP. Response to Parliamentary Question. 9th December 2020

[3] Analysis based on GP Patient Survey data which records long term mental health conditions and smoking status. Data available here on PHE fingertips tool.

[4] Chesney E, Goodwin GM, Fazel S. Risks of all‐cause and suicide mortality in mental disorders: a meta‐review. World psychiatry. 2014 Jun;13(2):153-60.

[5] NHS England. NHS Long Term Plan. January 2019