The Impact of a Smoking Cessation Policy on Visits to a Psychiatric Emergency Department

Abstract

Smoking cessation policies are increasingly imposed in mental health facilities because of the high prevalence of tobacco smoking and its related adverse health consequences. The objective of this study was to measure the impact of 2 smoking cessation policies--one imposed in a specific psychiatric hospital and the other across the entire province of Ontario--on weekly visit rates to a psychiatric emergency department. Administrative data records from consecutive patient visits to a psychiatric emergency department were grouped by week from March 1, 2002, to December 31, 2005. The patients were grouped into 3 broad diagnostic categories: substance-related disorders, psychotic disorders, and other disorders. The impact of 2 smoking cessation policies--one imposed on September 21, 2005 at the Centre for Addiction and Mental Health (CAMH) and one imposed on May 31, 2006 across the province of Ontario--on psychiatric emergency department visit rates was measured using time series analysis. The CAMH-specific smoking cessation policy had no impact on psychiatric emergency department visit rates in any diagnostic category. The province-wide smoking cessation policy resulted in a 15.5% reduction in patient visits for patients with a primary diagnosis of psychotic disorder. The benefits of a smoking cessation policy need to be balanced by the impact of the policy on the likelihood of patients to seek treatment.