Introduction:
This project was conducted by the Institute of Public Health for the Department of Health as part of a review of the Ten Year Tobacco Control Strategy for Northern Ireland (2012-2022). It aims to better understand the relationship between mental ill-health and tobacco use in Northern Ireland and configure a policy response.

Material and Methods:
This project included two workstreams. Workstream one (WS1) was a secondary analysis of the Health Survey Northern Ireland to assess the relationship between smoking status and mental ill-health. The second workstream (WS2) included documentary analysis of current official tobacco control policy documents/strategies in the UK and Ireland using the READ approach. Content was extracted to pre-selected questions, an assessment of commonalities and differences in the evolution of policy on tobacco and mental health was presented and key insights were reported.

Results:
WS1 found that twice as many people who smoke have a possible psychiatric disorder and four times as many people who smoke have probable clinical depression compared to those who never smoked. High proportions of people who smoke and have probable mental ill-health have tried to quit and expressed a desire to quit. WS2 resulted in 12 key insights including: knowledge gaps exist regarding smoking and chronic/life limiting mental illness, specific psychiatric diagnosis, and mental ill-health in children; more recent policy documents afford higher levels of recognition to mental health and frame responses at both the population and health service level; engagement with mental health service users within policy and programme development is growing but not universally or consistently applied; no policy set a specific target to reduce smoking prevalence among people with mental ill-health; a focus on training of mental health service providers in delivering stop smoking support is evident across all jurisdictions.

Conclusions:
This project found that although all policies recognise the relationship between mental health and smoking there are inconsistences in how it is both defined and understood. The most consistent action within the policies was training of mental health service providers in delivering stop smoking support but there are emerging examples of innovation in need of further evaluation.