1. Health Professionals against Tobacco Empowering psychiatric services to deal with tobacco control I want to quit Göran Boëthius MD, PhD Tobacco Control Unit Östersund Hospital Sweden Chair Doctors Against Tobacco 13th International Conference on Health Promoting Hospitals Dublin May 19, 2005

2. Health Professionals against Tobacco Smoking rates by mental health disorders (HDA 2004)

3. Health Professionals against Tobacco Often heavy smokers Makes them very sick Social welfare says ”quit first” Many want to quit It´s almost impossible to quit without adequate support It´s almost impossible to get adequate support Smoking among the mentally ill

4. Health Professionals against Tobacco It´s important to support psychiatric patients in smoking cessation There are effective treatments The treatment should be adjusted to the psychiatric patient´s special needs Smoking cessation

5. Health Professionals against Tobacco Plan the cessation process Strong nicotine dependence The disease in itself can prolong and complicate the process Intensive support over a long time The Quitting Process I

6. Health Professionals against Tobacco Nicotine replacement therapy (NRT) effective Bupropion (Zyban) - great care Depression - risk of new episode Monitor blood levels of neuroleptics The Quitting Process II

7. Health Professionals against Tobacco All psychiatric units should be smoke-free Provide NRT generously All professionals should be trained Policy recommendations for psychiatric care

8. Health Professionals against Tobacco It´s cynical to treat the psychiatric disorder and leave the patient to die from smoking

9. Health Professionals against Tobacco For more information Barbro Holm Ivarsson, Psychologists against Tobacco barbro.holm-ivarsson@fhi.se Göran Boëthius, Doctors Against Tobacco goran.boethius@jll.se Katarina Törnqvist, Nurses Against Tobacco katarina.tornqvist@sll.se Carina Altsjö, Pharmacy Against Tobacco carina.altsjo@apoteket.se