This study evaluated the effectiveness of a one-year smoking cessation intervention for people with severe mental illness compared with treatment as usual (TAU) in outpatient mental healthcare.

The KISMET study is a pragmatic cluster-randomized controlled trial conducted in 21 outpatient mental healthcare teams in the Netherlands. Eleven teams delivered the KISMET intervention comprising cognitive-behavioral and peer support, combined with optional pharmacological reatment. Ten teams participated in the TAU condition. We collected data between October 2022 and July 2024. The primary outcome was self-reported smoking cessation at 12 months, verified through exhaled carbon monoxide levels below 10 parts per million. Secondary outcomes included depression and anxiety (HADS), severity of psychotic symptoms (PANSS-6), quality of life (SF-12), disease self-management (PAM-13), lipid profile, blood pressure, body mass index, glucose level, and physical fitness. Crude and adjusted linear and multivariable logistic regression and mixed model analyses were performed.

Eighty-nine participants were included in the KISMET intervention and 44 in TAU. Smoking cessation rates were significantly higher in the KISMET group at 3 months (OR 12.1, 95% CI 1.4 to 103.7) and at 12 months (OR 4.2, 95% CI 1.0 to 17.2) but not at 6 months (OR 1.9, 95% CI 0.5 to 6.9). No significant differences between groups were found for secondary outcomes. Dropout rates were 58% in the intervention and 32% in the TAU group.

The KISMET intervention shows potential without signs of physical or psychopathological complications. However, results must be interpreted with the high dropout rates in mind.

Low parental income during childhood is associated with increased risk of mental disorders at later ages. However, despite a disproportionate share of migrant children growing up in persistent poverty, as compared to their majority counterparts, the research on whether the association varies by migrant background is limited.

Is there an association between parental income during early childhood and the risk of mental disorder, defined by use of outpatient mental healthcare services (OPMH), in adolescence and early adulthood? Does the strength of the association vary by migrant background?

Information from five national registers were combined to study a population of 577,072 individuals. We applied discrete-time logistic regression, with an interaction term between parental income and migrant background to study differences in the association by migrant background.

Low parental income during early childhood was associated with twice the odds of OPMH use in adolescence and early adulthood compared to individuals with higher parental income. Even after adjusting for a range of covariates the association remained significant, yet, weaker. The association was, however, in the opposite direction for migrants. Those in the higher income group had higher probability of OPMH use. The relative differences within groups were small, but significant for migrants from Middle East and North Africa, South Asia and Western countries.

Social inequalities in mental health may have an onset already in childhood, Therefore, future interventions should focus on reducing social inequalities in childhood in order to improve the mental health in young people.

No significant relationships.