Tobacco smoking and nicotine vaping in persons with first episode psychosis.

Tobacco smoking is highly prevalent in persons with psychosis and is the leading cause of preventable mortality in this population. Less is known about tobacco smoking in persons with first episode psychosis (FEP) and there have been no estimates about the prevalence of nicotine vaping in FEP. This study reports rates of tobacco smoking and nicotine vaping in young people with FEP enrolled in Coordinated Specialty Care programs in Pennsylvania and Maryland. Using data collected from 2021 to 2023, we examined lifetime and recent smoking and vaping and compared smokers and vapers to nonusers on symptoms, functioning, and substance use. The sample included 445 participants aged 13-35 with recent psychosis onset. Assessments were collected by program staff. Overall, 28 % of participants engaged in either smoking or vaping within 30 days of the admission assessment. Smokers and vapers were disproportionately male, cannabis users, and had lower negative symptom severity than non-smokers. Vapers had higher role and social functioning. Both smoking and vaping were related to a longer time from psychosis onset to program enrollment. We compare these findings to previous studies and suggest steps for addressing smoking and vaping in this vulnerable population.

Methods of training lay individuals in the use of evidence-based services for the management of mental and behavioral health disorders: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to describe how lay individuals have been trained in evidence-based therapies to manage mental and behavioral health disorders as defined by the International Classification of Diseases, version 11. INTRODUCTION: Health service delivery by lay individuals is common in under-resourced areas. Prior systematic reviews have examined the characteristics of lay workers, the types of services they provide, and the efficacy of their services. Our goal is to focus on the methods of training. INCLUSION CRITERIA: Participants will include lay individuals who provide services to community residents; we will exclude individuals with formal training in health service delivery. We will consider for inclusion studies that include training programs for evidence-based therapies delivered to individuals with mental and behavioral health disorders, and will exclude those involving pharmacology or focusing on cognitive defects. METHODS: We conducted a preliminary search of the literature on PubMed and CINAHL for articles related to the inclusion criteria and published in the past 10  years. Scanning the title, abstract, keywords, and MeSH terms, we generated comprehensive lists of terms and added search terms from 6 recent systematic reviews. Our search strategy will include MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science, and gray literature. We will also consult with experts and review the reference lists of articles selected for final inclusion. Articles published in English or Spanish between 1960 and the present will be considered for inclusion. Data analysis will use a mix of descriptive and qualitative approaches, with data presented graphically or in diagrammatic or tabular format.