Smoking and schizophrenia: The development of collaborative management guidelines

Objective: Smoking is generally on the decline, but more people with disorders such as schizophrenia smoke than is the rule for the general population. Collectively, health professionals in primary or specialist care settings probably do not do as much as they could to help these people cut down or give up, and the issues involved are more complex than they might at first appear. Assisting change in smoking patterns optimally will require collaboration between staff providing smoking-specific interventions such as group-based programs, and medical practitioners who can appropriately support transitions in smoking behaviour. Doctors providing this support should be aware of considerations specific to this group of patients including some relevant pharmacological interactions. This paper describes a project, which involved collaboration between provision of a group-based intervention and medical care including care within a GP shared-care program. A set of guidelines developed for doctors' use within this study has been adapted for wider use. Conclusions: Our experience with these guidelines, which are summarised in this paper, suggests they should be helpful for a range of clinicians working with people with schizophrenia who also smoke. The RACGP and the RANZCP have endorsed the guidelines, which are available from an internet website.