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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52

withmental illness are disadvantaged in receiving intervention and

support for their tobacco dependence, which is often overlooked

or even tolerated. This statement from the European Psychiatric

Association (EPA) systematically reviews the current evidence on

tobacco dependence and withdrawal in patients with mental ill-

ness and their treatment. It provides seven recommendations for

the core components of diagnostics and treatment in this patient

group. These recommendations concern: (1) the recording process,

(2) the timing of the intervention, (3) counselling specificities, (4)

proposed treatments, (5) frequency of contact after stopping, (6)

follow-up visits and (7) relapse prevention. They aim to help clini-

cians improve the care, health and well being of patients suffering

from mental illness.

Disclosure of interest

In the last three years, HJM received hon-

oraria for lectures or for advisory activities by the following

pharmaceutical companies: Lilly, Lundbeck, Servier, Schwabe and


He was president or in the Executive Board of the following organi-

sations: CINP, ECNP, WFSBP, EPA and chairman of the WPA-section

on Pharmacopsychiatry.


Smoking cessation and soft signs of

mental disorders

A. Batra

1 ,

, S. Eck



Psychiatry and Psychotherapy, Germany


University Hospital, Psychiatry and Psychotherapy, Tubingen,


Corresponding author.

Smoking is associated with major depression, schizophrenia, anx-

iety and compulsive disorders, personality disorders, or substance

abuse disorders

[1,2] . M

ore than that, smokers often report higher

levels of novelty seeking, anxiety or depressive symptoms without

fulfilling full diagnostic criteria for a psychiatric disorder.

In a former study, Batra et al.

[3] h

ad shown that smokers repor-

ting higher levels of novelty seeking/hyperactivity, depressivity,

and nicotine dependence evince higher relapse rates after comple-

tion of a six-weeks behavioural treatment program than smokers

reporting low scores on self-report psychological symptom meas-


Another study

[4] s

howed that a modified smoking cessation pro-

grammatched to at-risk smokers’ needs with


= 268 adult smokers

leads to higher long-term abstinence rates.

All at-risk smokers had been randomly assigned to receive either a

standard or modified treatment. Best results were shown for smok-

ers with mild depressive symptoms. The talk reports results of

former and recent studies and focuses on the German treatment

guidelines for tobacco related disorders.


[5] r

ecommend to assess tobacco use among patients with

mental disorders and should be offered smoking cessation sup-

port under consideration of the acuteness and the particularities of

the mental disorder using the same psychotherapeutic and phar-

maceutical measures as for smokers without additional mental


Disclosure of interest

Financial support by Pfizer, Parexel, SKB,

Novartis for smoking cessation studies.


[1] Batra A. Fortschr Neurol Psychiatr 2000;68:80–92.

[2] Rüther T, et al. European Psychiatry 2014;29:65–82.

[3] Batra A, et al. JSAT 2008;35:41–52.

[4] Batra A, et al. JSAT 2010;38:128–40.

[5] Batra A, et al. SUCHT 2016;62:139–52.


Smoking: A risk factor for suicide

H.J. Aubin

Univerity Hospital Paul Brousse, Addictologie, Villejuif, France

First demonstrated in 1976, the robust association between

smoking and suicide mortality has been established and is dose-

dependent, with an estimated increase in suicidal deaths risk of

24% for each increment of 10 cigarettes smoked per day. The statis-

tical association has been shown to exist very soon after smoking

initiation, during adolescence, and to withstand adjustments for

confounding factors, such as demographics, socio-economic sta-

tus, somatic and psychiatric comorbidity, and substance use. As

the underlying mechanism of the greater suicide risk in smok-

ers is not currently elucidated, we will briefly recapitulate the

main hypotheses proposed to date: the toxic effects of nicotine,

hypoxemia, monoamine oxidase activity inhibition, the high preva-

lence of psychiatric comorbidity and consequent suicide risk, and

smoking-induced serious physical illness with pain and disabil-

ity resulting in negative mood response. Smoking could also be

an inadequate self-medication for psychological symptoms, them-

selves causing suicide, and finally the association could be due to a

third underlying factor associated with both smoking and suicide.

Disclosure of interest

Henri-Jean Aubin was member of advisory

boards for Pfizer, D&A Pharma, Ethypharm, and Lundbeck, and has

received sponsorship to attend scientific meetings, speaker hono-

raria and consultancy fees fromBioprojet, D&APharma, Ethypharm,

Lundbeck, Merck-Serono, Novartis, and Pfizer.


Is it feasible and effective to help

patients with severe mental disorders

to quit smoking?

J. Bobes

University of Ovideo, Oviedo, Spain

Despite the proven association between smoking and high rates

of medical morbidity and reduced life expectancy in people

with severe mental disorders (SMD), their smoking rates do not

decline as they do in the general population. We carried out

a non-randomized, open-label, prospective, 9-month follow-up

multicentre trial to investigate the clinical efficacy, safety and

tolerability of a smoking cessation programme designed for the

treatment of patientswith SMD in the community under real-world

clinical conditions. A total of 82 patients were enrolled. Short-

term efficacy: The 12-week 7-day smoking cessation (self-reported

cigarettes per day =0 and breath CO levels

9 ppm) prevalence was

49.3%, with no statistically significant differences between medi-

cations (transdermal nicotine patches 50.0% vs. varenicline 48.6%,

chi-square =0.015,


= 1.000). Long-term efficacy: At weeks, 24 and

36, 41.3 and 37.3% of patients were abstinent, with no statistically

significant differences between treatments. Safety and tolerabil-

ity: No patients made suicide attempts or required hospitalization.

There was no worsening of the scores on the psychometric scales.

In both groups, patients significantly increased weight, without

significant changes in vital signs or laboratory results, with the

exception of significant decreases in ALP y LDL-cholesterol levels in

the varenicline group. Patients under varenicline more frequently

presented nausea/vomiting (


< 0.0005), patients under TNP expe-

rienced skin reactions more frequently (


= 0.002). Three patients

under varenicline had elevated liver enzymes. In conclusion, we

have demonstrated that in real-world clinical settings it is feasible

and safe to help patients with stabilized severe mental disorders to

quit smoking.

Disclosure of interest

Thisworkwas partly supported by the Span-

ish Ministry of Science and Innovation, Instituto de Salud Carlos

III (FIS PI10/01758) and Fondos Europeos de Desarrollo Regional