Stoptober - A Call for Action

PMHIC, The RCPsych blog

29 October, 2025

These monthly blog posts by the Public Mental Health Implementation Centre (PMHIC), 'Perspectives on public mental health', aim to highlight the voices of practitioners, patients, carers, and public health experts.

Welcome to this month’s blog post, by Dr Ed Beveridge, the RCPsych Presidential Lead on Physical Health and Dr Gavin Tucker, the RCPsych Presidential Scholar for Physical Health.

This blog post offers a clinical perspective for clinicians working in public mental health. It may also interest lived experience advisors, policymakers and researchers.

The truth about smoking

Most people . Supporting someone to stop smoking is a life-saving intervention. There has never been a better time to support someone to stop smoking, given policy commitments and the availability of treatments.

Health: Smoking is a of respiratory, cardiovascular, neurological, skin and bone diseases in our patients. People living with severe mental illness who also smoke r, on average, than the rest of the population.

Cost: Smoking is incredibly expensive for individuals and in terms of its costs to the NHS and wider society; it makes people poorer and intersects with many other health and mental health inequalities (). The National GP Patient Survey for 萝莉视频 shows that around 25% of adults with a severe mental illness smoke. This is double the level in the general population ().

Smoking and stress: a hidden cycle

Many people believe that smoking helps with stress. In the short term, nicotine can create a feeling of calm, but this feeling does not last. As nicotine leaves the body, it causes withdrawal symptoms like anxiety and irritability. This makes people reach for another cigarette. Over time, this cycle can make stress and anxiety worse.

Quitting smoking

Quit rates vary across groups. However, the NHS Tobacco Dashboard (accessed through collaboration platform login) shows that the most deprived 20% of the population have the highest successful quit rate. National research also shows that people accessing mental health services in 萝莉视频 have more success quitting than patients in acute trusts and maternity services.

Desire to quit: Most of our patients want to stop smoking, even when they are acutely unwell and have other priorities. The Quality Improvement in Tobacco Treatment Collaborative (QuITT), a quality improvement programme hosted by the National Collaborating Centre for Mental Health (NCCMH), found that two-thirds of smokers on inpatient wards engaged with a tobacco dependency advisor when one was offered.

Smoking as an addiction: Smoking is an addiction. However, when patients are given information about the benefits of stopping smoking and are offered medication and support from a tobacco dependence advisor service, research shows us that 58% of patients in mental health services stop smoking.

Support and treatment: We now have more tools at our disposal to help patients to stop smoking than ever before. Every mental health trust is expected to have tobacco dependency advisors, and several clinically proven, cost-effective medications are available.

Cytisinicline (also known as cytisine) was to aid smoking cessation. It should now be part of every region’s formulary. Cytisinicline is taken for 25 days, which is shorter than the average inpatient stay. As prescribers, we need to ask: “Why are we not offering cytisinicline to patients on wards if patients are already in hospital for other reasons, to support smoking cessation during this time?”

Better mood, less anxiety: Quitting smoking not only improves physical health but also lifts mood and lowers anxiety. After about 28 days, most people report feeling calmer, more in control, and more emotionally stable. The emotional benefits of quitting are just as important as the physical ones.

So how can you help?

Take the from the National Centre for Smoking Cessation and Training (NCSCT). It shows how to give Very Brief Advice (VBA) on smoking in under 30 seconds. Do it during your next CPD session and share it with your colleagues.
Contact your trust’s tobacco dependency advisor. Invite them to meet your team.
Read the RCPsych position statement on prescribing varenicline for mental health patients.
Prescribe the best evidence-based approach (see ): a combination of long- and short-acting nicotine replacement therapy (NRT).

Planning your next QI project?

If you are working on a QI project for Annual Review of Competency Progression (ARCP) or revalidation, smoking cessation is a strong choice. It includes measurable actions and directly supports health outcomes, patient safety, and care quality.

The following guidelines are recommended and may be considered in the development of quality statements:

Ensure that your patients are routinely asked about smoking status on entry.
Record the percentage of patients referred to tobacco dependency advisors.
Check your trust has varenicline and/or cytisinicline on formulary.
Record the percentage of patients prescribed combination long and short-acting NRT and are offered varenicline or cytisinicline.
Record the percentage of patients who have quit or cut down on smoking after 28 days of treatment.
Check the service has an enforced smoke-free policy.
Ensure that the use of Section 17 leave solely for smoking is explicitly prohibited.

Final thoughts

RCPsych is proud to support national smoking cessation work. Our upcoming Position Statement on Physical Health (due early next year) will include key recommendations on smoking cessation.

The names smoking cessation as a national priority, and it is likely that work on smoking cessation services will attract national funding.

Supporting someone to stop smoking is one of the single most effective actions you can take to help them build a healthier life. Most of our patients want to quit and most can succeed with the right help. As clinicians, we have a key role in promoting this truly life-saving intervention.

萝莉视频