In the United States, cigarette smoking is the main contributor to preventable death in all populations; and, among the mentally ill, the prevalence of smoking is a clinical practice concern. Nearly half of all smokers also have a diagnosis of mental illness compared with 23% of the general population. In an effort to reduce the problem of tobacco use within mentally ill populations, this project sought to create an educational module on smoking cessation for staff in a mental health clinic. The theory of planned behavior was used to guide the project that focused on implementation of a behavior change approach to counter smoking dependence. With evidence obtained from a comprehensive literature search of medical databases and textbooks, the education module was developed for teaching staff in a 30-bed outpatient mental health facility. Staff were taught to administer the education module on smoking cessation and to evaluate the plan. Evaluation of the project effectiveness on the knowledge of clinical staff was determined through the use of questions directed toward understanding professionals' perceptions of the module development and implementation, and the evidence-based educational materials developed for the program. Post tests administered after the staff education showed an increase in knowledge. The full education program was provided to the unit and will be used for staff training and for working with patients in the future. Positive social change is expected to occur because of the increased knowledge among clinical staff who care for mentally ill individuals who smoke. The result should be a safer, healthier setting for both smoking and nonsmoking patients in mental health clinics.

The aim of the present study was to investigate the role of metacognition as a mediator of the relationship between smoking dependence and depression/anxiety/ negative impact of life experiences. A sample of 202 adult smokers completed the following questionnaires: Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Life Experiences Survey (LES), Meta-Cognitions Questionnaire-30 (MCQ-30), and Fagerstr&ouml / m Test of Nicotine Dependence (FTND). The path analyses were used to test a mediation model in which depression, anxiety, or negative impact of life experiences was the predictor of metacognition, which in turn was a predictor of smoking dependence. Twelve mediation models were tested using total scores of metacognition, and its factors including positive beliefs about worry, negative beliefs about worry, lack of cognitive confidence, beliefs about need to control thoughts, and cognitive self-consciousness as mediator variables. The models included depression, anxiety, or negative impact of life experiences as independent variables / and smoking dependence as dependent variable. The results suggested that neither total metacognition score nor the individual metacognitive dimensions did mediate the relationship between smoking dependence and depression/anxiety/negative impact of life experiences. The results and limitations, as well as the implications of these findings, were discussed by referring to the relevant literature.