Public Health and Therapeutic Aspects of Smoking Bans in Mental Health and Addiction Settings

el‐Guebaly, Nady; Cathcart, Janice; Currie, Shawn R.; Brown, Diane R.; Gloster, Susan P.

doi:10.1176/appi.ps.53.12.1617

Cited by 104 publications

(103 citation statements)

References 55 publications

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“…[14][15][16][17][18][19] Facilities that offer mental health services often do not treat tobacco addiction 21,22 ; however, inpatient mental health and substance abuse treatment facilities with no-smoking policies have been successful in promoting smoking cessation, even among adolescents. 23,24 Monihan et al 25 reported that after implementing a smoking ban, some inpatient psychiatric facilities noted an increase in staff satisfaction and a significant decrease in violence and behavioral problems related to smoking habits. These results lend support to the recommendation that inpatient facilities should offer tobaccoaddiction treatment.…”

Section: Tobacco Use and Mental Illnessmentioning

confidence: 99%

Tobacco as a Substance of Abuse

Sims¹

2009

Pediatrics

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Tobacco use is the leading preventable cause of morbidity and death in the United States. Because 80% to 90% of adult smokers began during adolescence, and two thirds became regular, daily smokers before they reached 19 years of age, tobacco use may be viewed as a pediatric disease. Every year in the United States, approximately 1.4 million children younger than 18 years start smoking, and many of them will die prematurely from a smoking-related disease. Moreover, there is recent evidence that adolescents report symptoms of tobacco dependence early in the smoking process, even before becoming daily smokers. The prevalence of tobacco use is higher among teenagers and young adults than among older adult populations. The critical role of pediatricians in helping to reduce tobacco use and addiction and secondhand tobacco-smoke exposure in the pediatric population includes education and prevention, screening and detection, and treatment and referral.

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Section: Tobacco Use and Mental Illnessmentioning

confidence: 99%

Tobacco as a Substance of Abuse

Sims¹

2009

Pediatrics

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“…The underlying reasons for the strong relationship between smoking and mental illness are complex, and include neurobiological, psychosocial and genetic factors [7,8]. Smoking often constitutes a means of social interaction, reducing social inhibition and isolation encountered frequently in this population, and relieving boredom in treatment settings [7,9].…”

Section: Introductionmentioning

confidence: 99%

“…Smoking often constitutes a means of social interaction, reducing social inhibition and isolation encountered frequently in this population, and relieving boredom in treatment settings [7,9]. Smoking also induces liver enzymes responsible for clearance of some psychiatric medication, thus increasing drug clearance and necessitating higher medication doses [10].…”

Section: Introductionmentioning

confidence: 99%

Tailored tobacco dependence support for mental health patients: a model for inpatient and community services

2012

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Aims Although smoking prevalence among people with severe mental illness is high, it remains largely unaddressed. This pragmatic pilot project aimed to develop and implement a tailored tobacco dependence service in mental health settings and to assess its impact, as well as barriers and facilitators to implementation. Design An integrative service model, spanning acute, rehabilitation and community services, including the design of tailored instruments and referral pathways, delivered by two mental health professionals. Setting and participants Four adult acute and two rehabilitation wards (129 beds), and the community recovery team (2038 cases) of the United Kingdom's largest Mental Health Trust. Measurements Audit of smoking information in patient notes; service uptake; quit attempts; smoking cessation and reduction; qualitative data on implementation barriers/facilitators. Findings A total of 110 patients attended at least one support session: 53 inpatients (23% of inpatient smokers) and 57 community (of unknown number of community smokers, as recording of smoking status is not mandatory). Thirty-four of these (31%) made a quit attempt; 17 (15%) stopped smoking and 29 (26%) reduced cigarette consumption by up to 50% at the final contact. Barriers to service implementation related to: (i) trust policy, systems and procedures, (ii) staff knowledge and attitudes and (iii) illness-related factors. Conclusions Despite the strong anti-smoking climate in the United Kingdom, including a law requiring smoke-free policies in mental health settings, establishing a smoking cessation treatment service for people with mental illness proved difficult, due to complex systemic barriers. However, there is clearly a demand, by patients, for such a service.

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“…A review of 22 studies of total and partial smoking bans in mental health settings found no adverse effects in terms of unrest or refusal to comply (el-Guebaly et al, 2002). Lawn & Pols (2005) reviewed 26 international studies of smoking-bans in mental heath units, finding no increase in aggression, use of seclusion, discharge against medical advice or use of medication on an 'as required' basis.…”

Section: How To Implement a Smoke-free Policymentioning

confidence: 99%

How to implement a smoke-free policy

Cormac

McNally

2008

Adv. psychiatr. treat

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It takes courage, leadership and planning to successfully implement a smoke-free policy in mental health settings. The content of the policy is crucial in setting parameters for implementation. Management and clinicians should work closely together to develop and coordinate the implementation strategy, ensuring that resources are effectively used and deadlines are met. Key success factors are effective management at both central and local levels, as well as consultation with service users, carers and staff to gain support for the policy and obtain suggestions for improvement. Other important factors are advance planning, recruitment of experienced staff, effective communication and extensive training of staff in smoking cessation support. Local teams should develop appropriate procedures based on the policy. They should work closely with the central management team. The resources developed and obtained by local teams should be shared throughout the organisation and should be tailored to meet the needs of particular services.

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Public Health and Therapeutic Aspects of Smoking Bans in Mental Health and Addiction Settings

Cited by 104 publications

References 55 publications

Tobacco as a Substance of Abuse

Tobacco as a Substance of Abuse

Tailored tobacco dependence support for mental health patients: a model for inpatient and community services

How to implement a smoke-free policy

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