A digital place for people who access services, carers, staff and partner agencies, to share ideas around care co-ordination & care planning in mental health

Some interesting insights on smoking in hsopital…….

The Psychiatry SHO*

Last week the Mental Elf reviewed a research paper on the effects of smoke-free policies in psychiatric hospitals. It looks like some smokers manage to stay clear of cigarettes after being admitted to a hospital with a ban.

The debate about whether such bans are fair is complex and often heated, but can usually be boiled down to an argument between freedom (to smoke) and health (of the smoker and others). Contrary to my usual mindset, which is very freedom-orientated, I actually support smoking bans in psychiatric hospitals. I’d like to discuss why, not because I’m particularly ardent in my stance (in fact I used to be against them) but because it’s a tricky area in which I value both points of view. And before you ask, yes, I’ve been a smoker.

Firstly, let’s not forget – smoking is really, really dangerous. It wrecks the human body like nothing else, with smokers dying at least ten years before non-smokers on average. Furthermore,

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Comments on: "Smoking in psychiatric hospitals" (4)

  1. Pam Mareya said:

    We at Leeds and York Partnership Foundation Trust, are at the start of our journey to become a smoke free organisation by April 2016. As already stated smoking is the biggest preventable cause of death in England.

    Many people with mental health problems smoke and experience all of the physical problems associated with this. It is shocking that to know that 42% of all tobacco smoked in this country is by people with mental health problems, who therefore disproportionately experience tobacco related harm.

    Consequently smoking is responsible for most of the early deaths of people with severe mental health problems, and quitting smoking is the single most important lifestyle change that can be made to improve health and life expectancy of people with severe mental health problems.

    As a Trust we have carefully considered how we should respond to this. Many people have been involved in discussions about what we can do, including our Board of Directors and our Council of Governors. As a result we have decided that whilst service users are being cared for as inpatients, we will support them to temporarily abstain or quit smoking altogether.

    We recognise that this will have its challenges, but in thinking this through we also heard from a service user and carer where this is in place already in a Trust elsewhere so we know that it is possible. However it does need careful preparation and a twelve month programme of work will include training colleagues to ensure that we support service users with their nicotine management plans, be that abstinence or an attempt to quit. Over the coming months regular engagement events for service users, carers, and staff will take place to ensure their and your voice is heard, as we become a smoke free environment.

    Despite the challenges we are committed to doing the one thing that will improve the physical health and life expectancy of those who use our services.

    Liked by 1 person

    • I’m in favour of a complete smoking ban because as a non-smoker I don’t want to be around smokers if I am detained. However, surely it is clear that there is a difference between ‘supporting’ people to abstain or quit permanently, and forcing them to. As a patient, I think a smoking ban is necessary for non-smoking patients and staff. However, I believe this is unfortunate for detained smokers and I find it quite inappropriate for professionals to try and put a positive spin on this by using euphemistic terms like ‘support’ for what is blatant coercion. Better smoking cessation support for people who use services in the community or hospital and ask for support would be the one thing that would improve physical health, but forcing a physical health intervention on patients detained for mental health treatment is not.


  2. Maria said:

    I found this a really interesting debate.
    I am I non smoker who has sadly been an Inpatient more than once on a phychiatric ward, sectioned and informal.
    As a non smoker it’s easy for me to say I don’t agree with smoking allowed onwards/grounds because it could be said I don’t understand what it’s like to be a smoker etc but that’s not why I would be saying I believe psychiatric hospitals should be smoke free.

    I have this belief for a few reason. Firstly I have witnessed first hand patients waiting, gathering and becoming somewhat inpatient whilst wanting to go out side for a smoke. I have also seen what a long wait does to the people waiting. They become frustrated, they start yelling, shouting abuse at staff and other patients, they have become aggressive often needing several staff to calm them down. Meanwhile everyone else are told to go back to rooms etc which only causes more frustration to the ones who were waiting.

    This then also effects those not smoking. I have been caught in this cycle myself. I have asked staff for two minutes of their time as I wasn’t doing so well. Only to be told to wait. I would wait and wait and repeatedly go back to the desk to find no one about. This in part was due to other responsibilities but also due to the fact staff were outside with smokers and much to my annoyance having a quick fag too.
    After waiting a very long time I went back to the desk to be bombarded with my people nagging to go out for a smoke. I was yet again asked to wait only this time I was the one to become angry and frustrated. So I went back to my room and cut myself.
    Annoyingly I was “told off” for doing so and punished.
    This to me only annoyed me more.

    This brings me onto another point. Why is it acceptable for a smoker to use their coping strategy in hospital and even allowed to leave the ward even when on a section to help them deal with stress, anxiety, anger etc etc
    When I as a non smoker who uses different but can be said just as effective coping strategies I am punished. My coping strategies maybe somewhat harmful to myself but not others around me like smoke.
    Now I do somewhat understand and appreciate why self harm is not allowed on the wards but then why should smoking be?
    My self harm can be and I do personally contain it, do it safely and can deal with myself without help and for me it’s very effective in helping me deal with stressful situations like being sectioned where all control has been taken away.

    Anyway I’m going on but I felt I had a valid point or two, hope others can understand where I’m coming from.

    Thank you and I hope I’ve not caused any offence. I am very aware not all smokers behave in such ways not do all staff members. I apologise if I have.

    Liked by 1 person

    • Good points made; interesting insights to inpatient cultures too – really makes me think about ‘health’ in its broadest sense


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Dr Sally Pezaro

This is the research blog of Dr Sally Pezaro. Sally is 'The Academic Midwife' working to secure excellence in teaching and maternity services. Specialist interests include maternity services, workforce and midwifery research.



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