Evaluation of Treatment Components of a Smoking Cessation Program for Veterans with Serious Mental Illness

High cigarette smoking rates pose serious health risks for individuals with serious mental illness (SMI). Despite being as motivated to quit smoking as the general population, quit rates are lower and less research is focused on identifying effective smoking cessation interventions for individuals with SMI. This secondary data analysis examined the effectiveness of treatment components within a multifaceted smoking cessation intervention developed for Veterans with SMI (Bennett et al., 2015). The intervention offered five treatment components: (1) group sessions, (2) smoking cessation pharmacotherapy, (3) outreach contacts, (4) medication education sessions, (5) MI sessions. Participants could self-select use and dose of each treatment component. Attending a greater number of group sessions was significantly associated with lower nicotine dependence, greater abstinence self-efficacy, fewer cigarettes smoked per day, and greater likelihood of reporting a reduction in smoking post-intervention. Using a greater number of NRT/medications was significantly associated with lower nicotine dependence, fewer cigarettes smoked per day, greater confidence in quitting smoking, greater likelihood of reporting no smoking in the past week or month, and greater likelihood of reporting plans to quit smoking in the next month. Engaging in a greater number of medication education sessions was significantly associated with greater smoking reduction and fewer cigarettes smoked per post-intervention. Using a greater number of outreach contacts and MI sessions were not associated with any outcomes on smoking measures. Using a greater number of treatment components was associated with significantly lower nicotine dependence, fewer cigarettes smoked per day, and greater intentions to quit smoking in the next month, as compared to using fewer treatment components. Lastly, using a greater number of treatment encounters was associated with significantly lower nicotine dependence, fewer cigarettes smoked per day, and greater smoking reduction, as compared to using fewer treatment encounters. Smokers with SMI can engage in a multicomponent smoking cessation intervention and reduce their smoking. Future studies should explore creative ways to incorporate shared decision-making into smoking cessation intervention development for individuals with SMI.