The present study describes representations about smoking and practices related to patient smoking among staff of a large public psychiatric hospital. A survey was performed using a specially designed questionnaire. The return rate was 72.4% (n = 155). A large proportion of staff recognized the importance of both smoking status and mental health for patient's well-being (46.9%), and believed that smoking cessation was possible for psychiatric patients (58.6%). However, the role of the psychiatric hospital was perceived as providing information (85.3%) and helping to diminish cigarette consumption (51%), rather than proposing smoking cessation (29.5%). Staff daily practice included reminding patients of smoking restrictions (43.9%), managing cigarettes (46.5%), and nicotine replacement therapy (24.3%). A principal component analysis of tobacco-related practices revealed two main factors (59.8% of variance): basic hospital actions (factor 1) and more specialized interventions (factor 2), which were significantly associated with higher worries about personally developing smoke-related illnesses (Spearman r = 0.38, P < 0.0001). Compared with non-smokers, smokers reported higher perceived vulnerability to develop an illness due to tobacco and a higher level of worry about this. The discussion highlights the need to redefine roles and expectancies of mental health staff, and improve training and collaboration with experts, in order to improve efficiency concerning tobacco issues.

-Background and Objectives: Feasible interventions promoting tobacco cessation need to be implemented in psychiatric hospitals, where high proportions of patients are heavy smokers. This pilot study examined the feasibility of a new brief motivational intervention associating positive experiences with temporary smoking cessation.Methods: One-day interventions were proposed to 19 smokers hospitalized for severe mental disorders. The multicomponent intervention comprised a 25-hour tobacco cessation period, information about smoking, attending thermal baths and music therapy sessions, intensive group support and feedback sessions. Expired carbon monoxide was monitored and nicotine replacement was available. Patients were evaluated before, during and after the intervention.Results: Most participants were heavy smokers (68.4%) and precontemplative about smoking cessation (52.6%). Rates of successful smoking abstinence were 78.9% after 10 hours and 47.4% at 25 hours; 15.8% stopped for 3 days or more. Median CO level decreased from 24 to 9 ppm. Patients reported high levels of general well-being and satisfaction during the abstinence day. Psychiatric condition did not deteriorate and frequency of withdrawal symptoms was low. 84% of patients used nicotine replacement. Significantly reduced cigarette consumption persisted for at least one week after the intervention.

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