Nicotine dependence is significantly more prevalent in patients with mental illness, e.g. 60% in affective and 60%–90% in schizophrenia spectrum disorders, than in the general population (about 30%). Smoking not only causes physical diseases and increases mortality, but also negatively affects psychiatric disorders.

To evaluate the acceptance, practicability and efficacy of a programme to help psychiatric patients quit or reduce smoking and to characterise smoking psychiatric inpatients.

‘The smokers’ group’ is a voluntary, manualised, behaviour therapy group programme adapted to the special needs of psychiatric inpatients. It consists of six 75-minute open-group sessions. We recorded the smoking status of all psychiatric patients and evaluated the programme with standardised questionnaires.

In July 2012, 49.2% (116/236) of inpatients were active smokers (55% of men, 45% of women). From July 2012 to December 2013, 113 patients (56% women, 44% men; mean age 46 years) participated in ≥1 programme sessions. Median duration of smoking was 21 years and mean physical dependence was severe (5 on the FTND). Of those who completed ≥3 sessions, 23% (n = 26) roughly halved their cigarette consumption (from 22 to 10 cigarettes/d). Thirty-six (31%) stopped smoking, 30 with nicotine replacement. Eleven patients were abstinent after the programme, as verified by expired carbon monoxide.

Although smoking cessation is often difficult for psychiatric inpatients, they showed interest in the programme. about a third reduced or even stopped smoking. Adherence (high drop-out rate due to discharge and completely voluntary participation) and long-term followup require further attention.