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evidence-based nursing, mental health, tobacco cessation, tobacco use disorder



  1. Okoli, Chizimuzo T. C. PhD, MPH, MSN, RN
  2. Mason, Dia A. MSc
  3. Brumley-Shelton, Angela MPH
  4. Robertson, Heather MA


Objective: Individuals with mental illnesses (MIs) are disproportionately affected by tobacco-related disease burden because of higher tobacco use prevalence and poor tobacco treatment outcomes. This pilot study examines the outcomes of delivering an evidence-based tobacco treatment program (the Cooper-Clayton program) in a community mental health setting.


Design: A prospective nonequivalent group design was used to assess outcomes.


Sample: This study included 47 participants, of which 19 were in a community mental health setting and 28 were from two non-mental-health settings.


Measurements: Information on sociodemographic (gender, age, educational level, and current life stressors) and medical, MI, substance use, and tobacco use and cessation histories were obtained. Program completion and smoking cessation at the end of treatment (verified with expired carbon monoxide monitoring) were assessed.


Intervention: The program consists of combining behavioral counseling with nicotine replacement therapy for 12 weeks.


Results: Participants from the mental health setting were significantly less educated, had greater medical comorbidities, had greater psychiatric and mental health histories, and had greater perceived secondhand tobacco smoke exposure as compared with those from the non-mental-health settings. Thirty-two percent of the participants (6/19) completed the program in the mental health site as compared with 68% (19/28) from the non-mental-health site. None of those from the mental health site achieved cessation as compared with 68% of those from non-mental-health sites.


Conclusions: The differential outcomes of evidence-based tobacco treatment programs in non-mental-health versus mental health settings may suggest the need to modify existing tobacco treatment approaches for those with MIs in community settings.