Implementation of a smoke-free policy in an inpatient psychiatric facility: Patient-reported adherence, support, and receipt of nicotine-dependence treatment

Int J Ment Health Nurs. 2015 Aug;24(4):342-9. doi: 10.1111/inm.12128. Epub 2015 May 13.

Abstract

The implementation of smoke-free policies in inpatient psychiatric facilities, including patient adherence, mental health nursing staff support, and provision of nicotine-dependence treatment to patients, has been reported to be poor. The extent to which the quality of smoke-free policy implementation is associated with patient views of a policy is unknown. We conducted a cross-sectional survey of 181 patients (53.6%, n = 97 smokers; and 46.4%, n = 84 non-smokers) in an Australian inpatient psychiatric facility with a total smoke-free policy. Smokers' adherence to the policy was poor (83.5% smoked). Only half (53.6%) perceived staff to be supportive of the policy. Most smokers used nicotine-replacement therapy (75.3%); although few received optimal nicotine-dependence treatment (19.6%). Overall, 45.9% of patients viewed the smoke-free policy in the unit as positive (29.9% smokers; 64.3% non-smokers). For smokers, adhering to the ban, perceiving staff to be supportive, and reporting that the nicotine-replacement therapy reduced cravings to smoke were associated with a more positive view towards the smoke-free policy. These findings support the importance of patient adherence, mental health nursing staff support, and adequate provision of nicotine-dependence treatment in strengthening smoke-free policy implementation in inpatient psychiatric settings.

Keywords: nicotine dependence; patient acceptance of health care; psychiatric department; smoke-free policy; smoking.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Hospitals, Psychiatric* / organization & administration
  • Humans
  • Male
  • Middle Aged
  • New South Wales
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Smoke-Free Policy*
  • Smoking Cessation / methods*
  • Smoking Cessation / statistics & numerical data
  • Tobacco Use Cessation Devices
  • Young Adult