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Preparing for Completely Smoke-Free Mental Health Settings: Findings on Patient Smoking, Resources Spent Facilitating Smoking Breaks, and the Role of Smoking in Reported Incidents from a Large Mental Health Trust in England

Author

Listed:
  • Harpreet Sohal

    (UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology & Public Health, University of Nottingham, Nottingham NG5 1PB, UK)

  • Lisa Huddlestone

    (UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology & Public Health, University of Nottingham, Nottingham NG5 1PB, UK)

  • Elena Ratschen

    (UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology & Public Health, University of Nottingham, Nottingham NG5 1PB, UK)

Abstract

Introduction : Despite high smoking prevalence and excessive smoking-related morbidity and mortality among people with mental disorder compared to the general population, smoking treatment is often neglected in mental health settings. The UK National Institute of Health and Clinical Excellence (NICE) recently issued public health guidance stipulating completely smoke-free mental health settings. This project evaluated existing smoking-related practices in preparation for guidance implementation. The objectives were to: audit the recording of smoking-related information and treatment provision; explore current arrangements relating to the facilitation of patient smoking; measure staff time spent and identify costs of facilitating smoking; and explore the role of smoking in smoking-related incidents. Methods : A mixed-methods study was conducted across four acute adult mental health wards, accommodating 16 patients each, over six months. It included a case-note audit, on-site observations, and a qualitative content analysis of incident reports. Results : Smoking status was recorded for less than half of the 290 patients admitted (138, 48%). Of those, 98 (71%) were recorded as current smokers, of whom 72 (74%) had received brief smoking cessation advice. Staff spent 6028 h facilitating smoking, representing an annual cost of £131,040 across four wards. Incident reports demonstrated that smoking facilitation was often central to the cause of incidences, triggered frustration in patients, and strained staff resources . Conclusion : The findings highlight the importance and potential of implementing completely smoke-free policies using comprehensive pathways.

Suggested Citation

  • Harpreet Sohal & Lisa Huddlestone & Elena Ratschen, 2016. "Preparing for Completely Smoke-Free Mental Health Settings: Findings on Patient Smoking, Resources Spent Facilitating Smoking Breaks, and the Role of Smoking in Reported Incidents from a Large Mental ," IJERPH, MDPI, vol. 13(3), pages 1-12, February.
  • Handle: RePEc:gam:jijerp:v:13:y:2016:i:3:p:256-:d:64464
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    References listed on IDEAS

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    1. Sharon J. Lawn, 2004. "Systemic Barriers to Quitting Smoking among Institutionalised Public Mental Health Service Populations: A Comparison of Two Australian Sites," International Journal of Social Psychiatry, , vol. 50(3), pages 204-215, September.
    2. Elena Ratschen & John Britton & Gillian Doody & Ann Mcneill, 2010. "Smoking Attitudes, Behaviour and Nicotine Dependence Among Mental Health Acute Inpatients: an Exploratory Study," International Journal of Social Psychiatry, , vol. 56(2), pages 107-118, March.
    3. Satu Elo & Maria Kääriäinen & Outi Kanste & Tarja Pölkki & Kati Utriainen & Helvi Kyngäs, 2014. "Qualitative Content Analysis," SAGE Open, , vol. 4(1), pages 21582440145, February.
    4. Sharon Lawn & Jonathan Campion, 2013. "Achieving Smoke-Free Mental Health Services: Lessons from the Past Decade of Implementation Research," IJERPH, MDPI, vol. 10(9), pages 1-21, September.
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