Brief interventions for smoking or alcohol moderated by history of mental health condition: a national survey of adults in Great Britain 2020-2023

Abstract

Background: Individuals with mental health conditions can experience lower life expectancy, partly due to risk factors, such as smoking and alcohol use.

Objective: To assess potential differences in receiving support for smoking cessation or alcohol reduction in British general practice based on history of a mental health condition.

Methods: Self-reported data were collected between October 2020 and June 2023 from the monthly cross-sectional Smoking and Alcohol Toolkit Study. The sample included 23 790 adults who smoked in the past year and/or drank at risky levels (ie, Alcohol Use Disorders Identification Test-Consumption≥5). Outcomes included the receipt of brief interventions, the recommendations provided during brief interventions and quit or cut-down attempts triggered by healthcare professionals. Logistic regression models measured associations between outcomes and lifetime mental health history, without and with adjustment for demographic and behavioural factors.

Findings: Overall, 36.6% had a history of a mental health condition. About two-thirds of people with a history of a mental health condition and half of those without saw their general practitioner (GP) in the past year. Among those with a history of a mental health condition who saw their GP, 41.2% who smoked in the past year received smoking brief interventions and 7.0% who drank at risky levels received alcohol brief interventions. Receipt of smoking brief interventions was similar by history of mental health condition (with 41.2% vs without 41.1%). Individuals with a history of a mental health condition compared with those without had higher odds of receiving alcohol brief interventions (7.0% vs 2.8%, adjusted OR=2.69, 95% CI: 2.17 to 3.34) and receiving more comprehensive support as part of the intervention.

Discussion: Among respondents with a history of a mental health condition, only around 4 in 10 smokers who visited their GP received brief interventions from their GP and 1 in 20 for alcohol.

Clinical implications: Considering the links between smoking or risky drinking and mental health conditions, healthcare professionals should increase screening and brief advice to reduce health disparities.

Keywords: Cross-Sectional Studies; Depression & mood disorders; Substance misuse.