Factors associated with success of smokefree initiatives in Australian psychiatric inpatient units: Lessons for progressing smokefree mental health in the UK?

Authors and presenters:
Sharon Lawn
Senior Lecturer, Flinders Human Behaviour and Health Research Unit, Flinders University, Adelaide, Australia

Jonathan Campion
Consultant Psychiatrist, Department of Health, London, UK

Abstract
Internationally, there is increasing pressure on psychiatric care settings to adopt smoke-free policy. This study examined smoke-free policy across psychiatric inpatient settings in Australia and aimed to identify factors that may contribute to success or failure of smoke-free initiatives to better inform best practice in this important area. Semi-structured in-depth telephone interviews were conducted with senior administrators and clinical staff with direct day-to-day experience of smoking activities in 99 adult psychiatric inpatient settings across Australia (psychiatric units within general hospitals represented 58% of the national sample). Quantitative analysis, qualitative thematic analysis, and case studies were undertaken. The integration of a range of variables associated with leadership, teamwork, training, NRT use, staff smoking and other variables, as part of effective change management, were found to be important for implementing and sustaining smoke-free policy. Lack of staff cohesion was a significant factor found to undermine smoke-free policy. Features for success and ongoing sustainability of smoke-free policy were identified.
Leading on from this work, an audit of psychiatric units across England has been recently undertaken. Preliminary results will be presented, contrasting the two national audits and pulling together the common themes.

Ref: Lawn S. and Campion J. (in press) Psychiatric Services

Source of funding: The Australian study was supported in kind by the Flinders Human Behaviour and Health Research Unit, Flinders University.

The UK study is currently supported by a grant from The Department of Health, Chartered Institute of Environmental Health.

Declaration of interest: none

About the presenters
Sharon is a Senior Lecturer in the Department of Psychiatry, School
of Medicine at Flinders University in Adelaide, Australia. She undertakes research, and teaches across the graduate entry medical program and to graduate entry primary health care students, in the areas of chronic condition management/self-management, mental health and addictions. She has a long history as a clinical in public mental health inpatient and community services in Australia and in 2007 was recognised for her exceptional individual contribution to Mental Health Service in Australia and New Zealand, based on her work in the areas of Smoking and Consumer Participation.

Jonathan is a Consultant Psychiatrist on secondment from South London and Maudsley NHS Foundation Trust, London, UK to the Department of Health where he has been involved in the development of a public mental health strategy. He has published several articles highlighting the impact of smoking for those with mental illness.