Abstract

BackgroundIn 2008, a new forensic hospital was opened as a totally smoke-free facility. This study describes the attitudes and experience of mental health professionals working in the high secure mental health facility three years after it was opened. It is part of a larger evaluation describing the experience of current and discharged hospital patients.MethodsQuantitative data was collected using a survey of hospital staff (N = 111) with a 50% response rate. The survey collected demographic and smoking data to describe staff responses to statements relating to hospital smoking policy, patient care and staff support.ResultsAmong staff surveyed, 13% were current smokers and 41% were ex-smokers (10% quit after commencing employment in the smoke-free hospital). Most (88%) preferred to work in a smoke-free environment, although this was significantly lower in smokers compared to non-smokers (39% vs. 95%). While most staff felt that the smoke-free environment had a positive impact on the health of patients (86%) and on themselves (79%), smokers were significantly less likely to agree. Just over half (57%) of staff surveyed agreed that patient care was easier in a totally smoke-free environment, although less smokers agreed compared to non-smokers. Staff who smoked were also significantly less likely to indicate they had sufficient support working in a smoke-free environment, compared to non-smokers (15% vs. 38%).ConclusionsThe staff surveyed supported the smoke-free workplace policy; most agreed that patient care was easier and that the policy did not lead to an increase in patient aggression. Implementation of a total smoking ban can result in positive health outcomes for patients and staff, and may influence some staff to quit. Staff who smoke have a less positive experience of the policy and require additional support.

Highlights

  • In 2008, a new forensic hospital was opened as a totally smoke-free facility

  • Where policies have been effectively implemented in psychiatric inpatient facilities, key features include staff education and support, patient preparation, provision of nicotine replacement therapy (NRT) and an overarching strategy aimed at long term quitting incorporating evidence-based treatment and change in the smoking culture [8,13,14]

  • A survey of clinical and non-clinical staff in a large NSW psychiatric hospital conducted before the implementation of a total smoking ban revealed that while most staff thought the ban would improve their work environment, help staff stop smoking and improve the physical health of patients, they perceived barriers including the fear of patient aggression and likely patient non compliance [17]

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Summary

Introduction

In 2008, a new forensic hospital was opened as a totally smoke-free facility. This study describes the attitudes and experience of mental health professionals working in the high secure mental health facility three years after it was opened. Where policies have been effectively implemented in psychiatric inpatient facilities, key features include staff education and support, patient preparation, provision of nicotine replacement therapy (NRT) and an overarching strategy aimed at long term quitting incorporating evidence-based treatment and change in the smoking culture [8,13,14]. Staff knowledge and attitudes to smoke-free policy have been identified as barriers to the provision of dependence support for mental health inpatients. Smoking status of health care providers in mental health settings has been demonstrated to impact on attitudes to smoke-free policy, engagement in interactions related to tobacco and motivation to provide cessation support to patients [25,26,27]. Staff beliefs can significantly impact on the implementation of smoke-free policies within mental health settings, indicating a need for organisational responses to the local work environment [26,27]

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