Support and attitudes of Qatar mental health professionals to a proposed mental health inpatient smoking ban: Results of a cross‐sectional survey

Abstract

Accessible Summary What is known on the subject? Smoking is more common among people with serious mental illness, and it contributes to a reduced life expectancy. Several Western countries have successfully introduced smoke‐free policies in inpatient mental health units. There is virtually no information about attitudes to smoking bans in mental health units from countries in the Middle East and North Africa region. What the paper adds to existing knowledge? We surveyed mental health professionals working in Qatar's main mental health service to determine support for and attitudes towards a proposed total smoking ban in psychiatric wards. Most staff who completed the survey supported an inpatient smoking ban. However, further analysis, both quantitative and qualitative, showed markedly ambivalent attitudes, that is staff simultaneously held attitudes that supported and opposed a smoking ban. Professionals who did not support a ban were more likely to have not received smoking cessation training in the last 5 years, to be a psychiatrist rather than a nurse or allied mental health professional, to be current smokers and to be a Middle Eastern and North African national. What are the implications for practice? Further staff training is necessary to achieve more consistent attitudes that support a total smoking ban and increase the likelihood of successful implementation. The attitudes in this study showed similarities and differences to those reported for mental health professionals in Western countries. This highlights that local research is necessary to help shape training and successfully implement smoke‐free policies. Abstract IntroductionDespite the fact that patients with serious mental illness (SMI) have high rates of smoking and an increased standardized mortality, there is virtually no information about attitudes to smoking bans in mental health units from countries in the Middle East and North Africa region. AimTo assess support for, and attitudes towards, a proposed total smoking ban in psychiatric wards among mental health clinicians in Qatar. MethodCross‐sectional survey of mental health professionals working in Qatar's primary mental health service. ResultsThe response rate was 68% (353/520). Support for a ban was assessed with a single‐item question; 73% of respondents supported a ban with opposition significantly (p < .05) associated with being a current smoker, a Middle Eastern and North African (MENA) national, a psychiatrist versus a mental health nurse or allied health professional and not receiving smoking cessation training in the last 5 years. A 21‐item questionnaire assessed attitudes to a total smoking ban. It showed marked ambivalence with multiple linear regression identifying MENA nationality, male gender and current smoking status as independent variables influencing attitudes. The most strongly held attitude supporting a ban was concern about passive smoking and against a ban was concern it may increase patient agitation. Qualitative data confirmed ambivalent views. Discussi...

Hospital indicators and inpatient behavior in a psychiatric hospital that implemented the smoking ban

“…These results are important, as the fear of an increase in discharges on request and evasion is one of the main arguments of professionals who are against the smoking ban. This was evidenced in the statements obtained in a qualitative Brazilian study and in two quantitative studies carried out with professionals from Australia and Qatar, in which 93% and 73% of professionals, respectively, used this argument to defend their point of view regarding smoking bans (7,(16)(17) .…”

“…Studies conducted in Australia and Qatar show that the main argument against the smoking ban is the belief that patients will become more agitated and aggressive towards the team due to nicotine withdrawal (nine out of 10 professionals have these fears) (16)(17) . The confirmation of the hypothesis of a decrease in episodes of aggression with the implementation of the smoking ban provides answers to the concerns of the professionals.…”

“…The confirmation of the hypothesis of a decrease in episodes of aggression with the implementation of the smoking ban provides answers to the concerns of the professionals. It is interesting to note that studies carried out in Qatar and England show that professionals who received training in the approach to smoking in the psychiatric population were more in favor of the smoking ban than those who did not, demonstrating the potential of continuing education (16,26) .…”

“…The study was carried out in a philanthropic Public beds are divided into four inpatient units: 1) female (five beds for women with disorders related to the use of psychoactive substances and 15 for women with mental disorders); 2) male dependence (20 beds for men with disorders related to the use of psychoactive substances); 3) male disorders (20 beds for men with mental disorders) and 4) residents (31 men and 16 Oliveira RM, Santos JLF, Furegato ARF.…”

Indicadores hospitalarios y comportamiento de pacientes internados en hospital psiquiátrico que adoptó la prohibición de fumar

“…Los resultados de este estudio son importantes, ya que el recelo de aumento de altas a pedido o por evasión es uno de los principales argumentos utilizados por los profesionales para justificar porque son contrarios a la prohibición de fumar. Eso fue evidenciado por medio de declaraciones obtenidas en un estudio cualitativo brasileño, así como en dos estudios cuantitativos realizados con profesionales en Australia y Catar, en los cuales 93% y 73% de los profesionales utilizaron, respectivamente, ese argumento para defender su punto de vista contrario a la prohibición (7,(16)(17) .…”