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
Harpreet Sohal, Lisa Huddlestone and Dr Elena Ratschen
Presenter(s)
Harpreet Sohal Research Assistant/Trainee Health Psychologist, UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology & Public Health, The University of Nottingham
Dr Elena Ratschen Senior Lecturer in Health Services Research, Department of Health Sciences, University of York
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 National Institute of Health and Clinical Excellence issued 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 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 related incidents. Methods: A mixed-methods study was conducted across four acute adult mental health wards and 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 smokers, of whom 72 (74%) received brief cessation advice. Staff spent 6028 hours facilitating smoking, representing an annual cost of £131,040 across wards. Incident reports demonstrated that smoking facilitation was often central to the cause of incidences, triggered patient frustration, and strained staff resources. Conclusion: The findings highlight the importance and potential of implementing completely smoke-free policies using comprehensive pathways.
Source of funding: Cancer Research UK have funded the current study.
Declaration of interest: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.
