Comparison with the existing literature
low mood, irritability, mental illness
Integrated smoking cessation and mental health treatment was generally accepted, and participants had the capability to understand their smoking behaviour in the context of the tobacco withdrawal cycle and engage in treatment. These findings further those from our qualitative study of IAPT patients' views of integrated treatment, which found that IAPT patients accepted evidence that smoking may worsen their mental health and that quitting could improve their mental health.Although most participants described their smoking using a CBT model and identified withdrawal as a component of their mental illness, some participants described withdrawal and mental illness as different experiences. This contrasts with the literature on the tobacco withdrawal cycle, which suggests that irritability and low mood from nicotine withdrawal are the same experience as mental illness.This study found that an important factor for smoking cessation intervention uptake is having smoking cessation treatment available and offered in primary care services. This finding is in line with a systematic review that found that offering all smokers help to quit increased quit attempts, compared to telling them to quit.Participants were motivated to accept and engage with the integrated smoking cessation and IAPT therapy, consistent with a systematic review indicating that people with mental illness are motivated to quit smoking.Previous literature has suggested that altruism is an important motivator for participation in mental health trials.