European Psychiatry - Volume 41 - April 2017

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S32 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
Bayer.
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.
S079
Smoking cessation and soft signs of
mental disorders
A. Batra ∗, S. Eck
1 Psychiatry and Psychotherapy, Germany
2 University Hospital, Psychiatry and Psychotherapy, Tubingen,
Germany
∗ Corresponding author.
Smoking is associated with major depression, schizophrenia, anx-
iety and compulsive disorders, personality disorders, or substance
abuse disorders 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. 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-
ures.
Another study howed that a modified smoking cessation pro-
grammatched to at-risk smokers’ needs with n = 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.
These 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
disorders.
Disclosure of interest Financial support by Pfizer, Parexel, SKB,
Novartis for smoking cessation studies.
Reference
[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.
S080
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.
S081
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, P = 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 ( P< 0.0005), patients under TNP expe-
rienced skin reactions more frequently ( P= 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