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The SCIMITAR programme consists of the SCIMITAR and SCIMITAR+ trials which explore the clinical effectiveness and cost effectiveness of a bespoke smoking cessation intervention for people with severe mental ill health.
The problem
The problem
People with severe mental illness such as schizophrenia or bipolar disorder are three to four times more likely to smoke than people in the general population. Smoking contributes to poor health, poverty and early death in people with SMI, who on average die 20 to 25 years earlier than those without.
Smoking makes a significant contribution to this health inequality. Whilst smoking rates are falling in the general population, they have remained unchanged among people who use mental health services. For these reasons, it is clear that conventional approaches to smoking cessation might need to be tailored to people with SMI.
The trial
The trial
The team developed a bespoke smoking cessation intervention to help people with SMI cut down or quit smoking. This intervention was tested in the SCIMITAR pilot trial which successfully recruited and followed up 97 participants and found that the BSC intervention was acceptable to people with SMI.
Following the pilot trial the SCIMITAR+ trial was conducted to evaluate the clinical effectiveness and the cost effectiveness of the SCIMITAR intervention. The SCIMITAR+ trial recruited 526 people who were randomly allocated to either the BSC intervention or usual smoking cessation services.
The findings
The findings
The SCIMITAR+ trial found that after six months, participants who received the bespoke intervention were twice as likely to have quit smoking than those who received usual care. At 12 months participants who received the bespoke intervention were still more likely to have quit but the difference in quit rates was not statistically significant.
SCIMITAR+ is the largest trial to date of a smoking cessation intervention for people with SMI, but this was underpowered to detect anticipated long term quit rates. By pooling pilot and full trial research data it was found that quit rates are maintained in the long term. Policymakers can now be confident that bespoke smoking interventions produce successful short and long term quit rates.
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