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Few psychiatric units have banned smoking


Few psychiatric units in England have fully implemented a total ban on smoking nearly a year after it came into effect, according to a survey by the Mental Health Foundation.

The results, published in a report – Death of the smoking den: The initial impact of no smoking legislation in England in 2008 – show that 85% of the 109 units that responded said the ban had been implemented only partially, or not at all, effectively. The ban came into effect on 1 July 2008. 

Respondents indicated many practical problems arising from the ban’s implementation such as a rise in ‘secret smoking’ and occasions where staff felt they needed to ‘turn a blind eye’, particularly when patients are very unwell. 

Additionally many units lacked a safe outdoor space where patients can smoke. Even where such a space existed, respondents said the need to escort patients outside to smoke was a considerable drain on staff time.

Respondents also reported feeling uncomfortable with their enforcement role. Some staff reported feeling more like police than nurses, while others cited incidents of aggression linked to the ban. 

Simon Lawton-Smith, head of policy at the Mental Health Foundation, said: ‘The ban on smoking inside mental health units is justified on public health grounds, and we support it.  However, while the ban has been successful in some cases, the findings of this survey suggest that there have been widespread practical problems.’


Should psychiatric units be an exception to the public smoking ban?

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Readers' comments (3)

  • Dear Sir ,
    Let's get real .About three quarters of the seriously mentally ill smoke .Why ? Because community care has been deliberately unresourced by right wing governments so many service users have to be admitted unnecessarily and often for too long , not just long enough .The public do not really tolerate the mentally ill in the community .The service users are stressed and therefore smoke.Only people with little or no front line experience talk about total bans (even though most front line workers can see the health benefits) .It would be more realistic for all service users that smoke to have mandatory smoking cessation care plans , whether they are in patients or in the community .

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  • Agreed. I can't imagine how much more unsettled our ward would be without the smoking breaks. Some patients practically live for them. Most only smoke because others do, and because it is a chance to get off the ward/go outside.

    There would be a lot more violent incidents against staff and patients if these were outright banned. If the ban was put in place by trusts, it would need to be done gradually, i.e removing one smoke break a month for example. As let's not forget, some of these people are really ill, and will not take lightly to you taking away their time of the day.

    If this really is to be put in place then trusts need to staff up! There's no way I would continue to work on a ward with an immediate ban on smoking, there would be riots! No seriously..we already have problems with patients secreting lighters. It's a knock on effect, there would be more fire alarms and more call outs, in the long run, the trusts would run up a mighty bill with the fire department.

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  • There is also the serious issue of increased aggression having to enforce the smoking law. In South Shields recently a nurse was stabbed trying to do this. By turning a blind eye she would have been breaking the law; by adhereing to this she was seriously injured. Is it no wonder it hasn't been fully implemented.

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