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Psychiatr Serv. 2018 Aug 1;69(8):849-851. doi: 10.1176/ Epub 2018 Jun 1.

Low-Burden Strategies to Promote Smoking Cessation Treatment Among Patients With Serious Mental Illness.

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Dr. Chen, Dr. Brownson, and Dr. Bierut are with the Siteman Cancer Center and Institute of Public Health Sciences, and Dr. Chen and Dr. Bierut are also with the Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis. Dr. Brownson is also with the School of Social Work, Washington University in St. Louis. Dr. Baker is with the Center for Tobacco Research and Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison. Dr. Korpecki, Dr. Johnson, and Dr. Hook are with BJC Behavioral Health, BJC Healthcare, St. Louis. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column.


Patients with serious mental illness have high smoking prevalence and early mortality. Inadequate implementation of evidence-based smoking cessation treatment in community mental health centers (CMHCs) contributes to this disparity. This column describes a study of the effects of quality improvement strategies on treatment and cessation outcomes among patients with serious mental illness at four CMHCs. Two low-burden strategies, decision support and academic detailing with data-driven feedback, were implemented in the CMHCs' clinics from 2014 to 2016. Pre- and postimplementation data from pharmacy and medical records were analyzed. The percentage of patients receiving cessation medication increased from 5% to 18% (p≤.001), and smoking prevalence decreased from 57% to 54% (p≤.001). This quality improvement approach holds great potential for increasing the level of smoking cessation care for patients treated in CMHC settings. Decision support and academic detailing with feedback may be effective strategies to promote best practices.


Community Mental Health Center; Mental illness & Smoking cessation; Practice guidelines; Smoking

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