Led by Dr Gemma Taylor at the University of Bath, alongside researchers from several other institutions, the study published in Addiction also found that adding smoking support to mental health treatment didn’t disrupt therapy. Instead, it offered a practical way to tackle mental and physical health together.
About the Study
The trial was conducted across four NHS trusts in the Midlands, London and the South-west of England between 2019 and 2021. It tested the practicality of integrating smoking cessation support with NHS-funded cognitive behavioural therapy (CBT) for depression and anxiety.
A total of 135 people were split into two groups:
One group received 12 sessions of smoking cessation support as part of their CBT session. The other group had standard CBT and were given information about quitting smoking after treatment. Researchers followed up at three and six months to measure engagement, satisfaction, smoking habits, and mental health outcomes.
Key Findings
Quit Rates at 6 Months: At six months, 15% of the combined treatment group had quit smoking entirely – more than two and a half times the quit rate of the control group (6%). Impact of CBT on Smoking Cessation in Depression: A Cochrane review reported an 8.8% quit rate for standard smoking cessation treatments among individuals with depression. Findings from the ESCAPE trial reveal that incorporating cognitive-behavioral therapy (CBT) nearly doubles this rate. The researchers think this study could open the door to bringing smoking cessation support into more mental health services. Therapists are backing the intervention, saying it is both helpful and easy to use, improving clients' mental and physical health.
Responding to the promising findings, lead Researcher Dr Gemma Taylor from the Department of Psychology at the University of Bath said:
"People with depression and anxiety are twice as likely to smoke and quitting is one of the most powerful ways to improve both physical and mental health. This study shows that by addressing smoking alongside mental health treatment, the NHS can offer patients a chance to break free from a deadly cycle, improving their well-being in a way that’s practical, effective and life-changing."
Hazel Cheeseman, Chief Executive of Action on Smoking and Health (ASH) said:
“The NHS is letting down people who both smoke and live with depression and anxiety by addressing these issues in silos. By combining treatment people will see both their physical and mental health improve with long term benefits to them and the healthcare system.
“If Wes Streeting wants to shift the NHS from ‘sickness to prevention’ it must find smarter ways to improve people's health. This is a ready-made solution that can be slotted into existing services. We will be calling for follow up studies to see if outcomes can be replicated and services scaled up for all.”
Mark Rowland, Chair of the Mental Health and Smoking Partnership and Chief Exec of the Mental Health Foundation said:
“Quitting smoking not only reduces your risk of cancer and heart disease, it is also one of the best ways to improve your mental health and wellbeing. This study shows that the NHS could be doing much more to support people struggling with their mental health to quit smoking. We hope to see a rapid expansion of this model to help more people break out of the cycle of stress and addiction caused by smoking.”
Tom Ayres, Director of the National Collaborating Centre for Mental Health said:
"People with mental health conditions are just as motivated to quit smoking as the general population but face greater barriers to doing so. This research shows that stop smoking support can be embedded in Talking Therapies programmes to help people address their tobacco addiction alongside their mental health. This approach should be scaled up to ensure that people with mental health conditions get the support they need to be smokefree.
Dr Gemma Taylor said:
"Expanding smoking cessation within NHS mental health services isn’t just a smart choice - it’s a crucial step toward improving patient outcomes and building healthier communities.”
Finding better ways to help people with depression and anxiety to quit smoking
People with depression and anxiety are twice as likely to smoke compared to the general population, with 26% of this group in the UK identified as smoking. NHS Talking Therapies were accessed by 1.2 million people last year, meaning this smoking support could reach up to 300,000 people who smoke each year. Evidence suggests that smoking may be contributing to poor mental health. A recent study by Dr Taylor shows that stopping smoking improves mental health as much as taking anti-depressants. This study provides a practical and novel way to address high smoking rates in this population and improve physical health inequalities experienced by people with depression and anxiety. ENDS
For more information, please contact Rebecca Tanswell at the University of Bath press office: 01225 386319 or email rlt54@bath.ac.uk
Notes to editors
Link to paper will go live when published 00.01 GMT 12 March 2025: https://onlinelibrary.wiley.com/doi/10.1111/add.16718
The research was funded by Cancer Research UK with additional funding from UKRI, the University of Bristol, the Higher Education Funding Council for England and NIHR.
The NHS Trusts that took part in the trial: Avon and Wiltshire Partnership NHS Trust, Oxford Health NHS Foundation Trust, Northeast London Foundation NHS Trust and Dudley and Walsall Partnership NHS Trust.
The study took place between June 2019 and August 2021
Conflicts of Interest: Gemma Taylor previously worked at a health economics research consultancy providing statistical and research support for pharmaceutical companies for medicines unrelated to this manuscript.
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