Smoking cessation treatment among addicted populations in Brazil

In Brazil, despite the availability of treatment for regular smokers through large national programs (such as the Brazilian National Cancer Institute  and Program for the Assistance of Addicts,) mental health and addiction (MHA) patients have received little help to combat smoking – even though the prevalence of smoking among MHA patients is 2-4 times higher than that of the general population.

The treatment of smoking among MHA patients appears to be beneficial and recent studies have highlighted treatment as a variable related to smoking cessation in this population. The low level of treatment is largely due to a lack of information and false perceptions among health professionals regarding the treatment of smoking in this group of patients. Recent studies show that success rates in quitting smoking and retention in treatment are at least comparable to the general population, since the treatment of smoking is incorporated into ongoing treatment for mental disorders or other addictions.

Psychosocial units (CAPS – Centros de Atenção Psicossocial) promote public comprehensive care for people with severe and persistent mental disorders in Brazil. Psychosocial units for alcohol and drugs (CAPS-AD) are specifically designed for individuals with substance use disorders, and are largely integrated with the regular CAPS units (designed for mental health disorders.) These units (CAPS and CAPS-AD) have staff from multiple professions and, in my opinion, represent the most interesting locations for treating smoking in MHA patients.

Almost all of the recommendations made in previous studies focused on smoking treatment for MHA patients can be implemented in these health units. Because CAPS and CAPS-AD staff teams include professionals who specialize in mental health and addiction disorders, it is possible to integrate smoking cessation treatment with ongoing psychiatric and/or addiction treatment. Reflecting best practices identified in recent studies, professional care is available during business hours (in some units, 24 hours a day) for any clinical need from patients who are undergoing smoking treatment and other regular treatments for mental health and addiction disorders.