Cessation in Mental Illness
Cessation in Mental Illness integrates tobacco, vaping, and nicotine treatment into psychiatric care so symptom relief and cardiometabolic health advance together. This page translates evidence into clinic workflows—universal screening, “opt-out” offers of help, and tailored quit plans for people living with depression, anxiety, bipolar disorder, psychosis, and SUD. If you’re comparing an addiction cessation conference, you’ll find stepped pathways that combine behavioral support with pharmacotherapy (NRT, varenicline, bupropion) while protecting sleep and mood. Stigma-free messaging, practical problem solving, and parity-aligned policies help teams close the mortality gap driven by commercial tobacco and nicotine products.
Real-world success depends on timing, dose, and follow-through. Quit attempts align with medication reviews, pain and sleep plans, and relapse-prevention scripts; varenicline or combination NRT address high dependence, while bupropion supports mood and attention when appropriate. We emphasize harm-reduction on the way to abstinence—clean nicotine, fewer triggers, and contingency plans for stress peaks. Staff training, pharmacy partnerships, and ePRO dashboards keep momentum visible, and warm handoffs to peers and quitlines extend reach beyond clinic walls. For policy and population strategies, see Global Tobacco Control, which complements this page’s focus on bedside implementation.
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Assessment and readiness mapping
- Normalize questions, gauge dependence, and identify triggers across the day.
- Link cessation benefits to patient goals—breath, sleep, meds, and money.
Medication strategy and sequencing
- Start varenicline or combination NRT for high baseline use; add bupropion when indicated.
- Adjust doses for psychiatric meds, hepatic/renal status, and sleep considerations.
Behavioral support and relapse planning
- Use brief MI and CBT skills—stimulus control, urge surfing, coping scripts.
- Schedule check-ins around risk windows and build rapid re-entry plans.
Equity, language, and access
- Provide free/low-cost options, translators, and culturally adapted materials.
- Reduce system barriers—prior auths, refill gaps, and transport costs.
Implementation Models and Practice Tools
Opt-out offers in all settings
Make cessation the default in ED, inpatient, and outpatient psychiatry.
Combination therapy playbook
Pair long-acting patch with short-acting NRT or varenicline for breakthrough urges.
SUD and psychosis pathways
Align with MOUD/AUD care; monitor caffeine and antipsychotic levels when quitting.
Digital and quitline integration
Text nudges, apps, and quitline referrals with scheduled callbacks.
Sleep and circadian support
Stabilize routines; avoid sedative stacking during early quit phases.
Pregnancy and perinatal care
Risk–benefit counseling, preference-sensitive choices, and close follow-up.
Peer and family supports
Lived-experience coaching and household smoke-free agreements.
Measurement and QI
Track 7/30/90-day abstinence, cut-down rates, PROMs, and equity metrics.
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