{
  "abstract": "Objective To identify values and preferences regarding smoking cessation interventions among adults with severe mental illnessDesign Systematic review with best-fit framework synthesisData sources MEDLINE, EMBASE, Web of Science, CINAHL and Scopus from inception to 14 November 2025.Study selection Studies with any design, in any clinical and geographical setting, reporting on adult (18+) current or past smokers with a diagnosis of schizophrenia, bipolar or mood disorder, including major depressive disorder or post-traumatic stress disorder. We selected all quantitative and qualitative findings regarding patients’ values and preferences, including beliefs, attitudes, behaviours and perceived barriers and facilitators, in relation to smoking cessation interventions.Data extraction and synthesis Two reviewers independently screened studies. After a pilot to increase accuracy, data were extracted by one reviewer and verified by another. Risk of bias was assessed using the Mixed Methods Appraisal Tool. We used the best-fit framework synthesis methodology to synthesise the data.Results Of 14 970 identified articles, 65 were included. Most studies were of moderate to high quality. Financial costs posed a significant barrier, while education and social support emerged as important facilitators. Patients preferred personal interactions with healthcare providers. Their motivation for cessation varied and was influenced by habits and perceived nicotine dependence. Health concerns and financial savings were primary drivers for reflective motivation. Beliefs regarding treatment varied. Although commonly used, scepticism about nicotine replacement therapy and concerns about the long-term safety of electronic delivery systems were reported. Overall, patients preferred personalised, flexible programmes and emphasised the need for tailored approaches. Digital interventions, especially mobile apps, that provide support, motivational content and relevant information, were perceived as appealing and helpful when sufficiently considering accessibility and usability aspects. Patients commonly perceived smoking as a coping mechanism for negative emotions. Developing new coping strategies and creating smoke-free environments were deemed to contribute to successful cessation.Conclusions Patient-centred care for people with severe mental illness should leverage behavioural and pharmacological strategies for smoking cessation. Flexibility, accessibility and ongoing support appeared important for addressing stress, withdrawal symptom interpretation and relapse vulnerability in this population.PROSPERO registration number CRD42022337933.",
  "authors": [
    {
      "affiliations": [
        "Department of Family Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands",
        "Department of Public Health and Primary Care, Academic Center for General Practice, KU Leuven, Leuven, Flanders, Belgium"
      ],
      "name": "Kristien Coteur"
    },
    {
      "affiliations": [
        "Psychiatric Hospital, Alexianen Zorggroep Tienen, Tienen, Belgium"
      ],
      "name": "Laura Tops"
    },
    {
      "affiliations": [
        "Department of Public Health and Primary Care, Academic Center for General Practice, KU Leuven, Leuven, Flanders, Belgium"
      ],
      "name": "Geertruida E Bekkering"
    },
    {
      "affiliations": [
        "Department of Public Health and Primary Care, Academic Center for General Practice, KU Leuven, Leuven, Flanders, Belgium"
      ],
      "name": "Louise de Almeida Ferreira Fonseca"
    },
    {
      "affiliations": [
        "Department of Family Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands"
      ],
      "name": "Floor van den Brand"
    },
    {
      "affiliations": [
        "Community Health Clinic De Bruggen, Bruges, Belgium"
      ],
      "name": "Hanne Cloetens"
    },
    {
      "affiliations": [
        "Department/Evidence-based Pharmacy Centre/Children’s Medicine Key Laboratory of Sichuan Province, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China"
      ],
      "name": "Linan Zeng"
    },
    {
      "affiliations": [
        "Department of Public Health and Primary Care, Academic Center for General Practice, KU Leuven, Leuven, Flanders, Belgium"
      ],
      "name": "Bert Aertgeerts"
    },
    {
      "affiliations": [
        "Department of Public Health and Primary Care, Academic Center for General Practice, KU Leuven, Leuven, Flanders, Belgium"
      ],
      "name": "Nicolas Delvaux"
    },
    {
      "affiliations": [
        "University of Alberta, Edmonton, Alberta, Canada",
        "MAGIC Evidence Ecosystem Foundation, Oslo, Norway"
      ],
      "name": "Arnav Agarwal"
    },
    {
      "affiliations": [
        "MAGIC Evidence Ecosystem Foundation, Oslo, Norway",
        "Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland",
        "Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Alberta, Canada"
      ],
      "name": "Thomas Agoritsas"
    },
    {
      "affiliations": [
        "Solidaris, Brussels, Belgium"
      ],
      "name": "Mieke Vermandere"
    }
  ],
  "title": "Values and preferences of patients with severe mental illness regarding smoking cessation interventions: a systematic review with best-fit framework synthesis",
  "uid": "e46e4040-471d-5d69-82af-d9710aa58942"
}