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Smoking ban may reduce violent incidents within psychiatric units

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Banning smoking in inpatient mental health settings may prove successful in cutting violent incidents, UK research has suggested.

When smoking was restricted at a psychiatric hospital more than two years ago, incidents of patient violence almost halved, researchers said.

The findings go against previous views that being able to smoke has a calming effect on patients in mental health settings.

The team from Harplands Hospital in Stoke-on-Trent examined all recorded episodes of violence and aggression witnessed by staff.

All incidents that had occurred a year before the introduction of a smoke-free hospital policy in April 2006 were compared with
all those that occurred a year after. Under the ban staff and patients could only smoke in designated areas outside the hospital.

From 1 July this year, the Department of Health introduced a similar smoke-free policy for all psychiatric hospitals in England.

The researchers at Harplands Hospital said 1,294 violent incidents were reported between April 2005 and April 2006. This fell by 43% to
738 between April 2006 and April 2007.

Previous evidence on the views of psychiatric staff revealed that the findings were not those expected, the researchers noted.

A 2006 study of 151 mental health units found staff consistently said they thought that rules to restrict smoking would increase agitation and violence among patients.

Roger Bloor, a senior lecturer in addiction psychiatry at Keele University Medical School, said: ‘Before the ban, patients were smoking in the smoking rooms and staff were reluctant to go in – it
was a very smoky, nasty atmosphere. Getting rid of those smoking rooms means that staff are now more accessible to patients.’

The research was presented last month at a Royal College of Psychiatrists conference in London.

Brian Rogers, professional officer for the Mental Health Nurses Association, said the findings, while unexpected, were very welcome.

However, he cautioned that it needed to be seen if the ban resulted in ‘long-term behavioural change’.

‘We need to look at how we maximise this for a long-term health gain,’ he said.

A major report on acute inpatient mental health services in England, published earlier this month by the Healthcare Commission, found that 45% of nurses had been subjected to physical violence last year (NT News, 29 July, p6).

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Readers' comments (1)

  • This is a poor piece of research and the findings are not clear.The smoking ban has been a headache for staff and patients.The anti smoking lobby have had a free reign on this one..The vast majority of nurses,psychiatrists,HCA's and service users think it unfair and a paternalistic initiative.There must have been a third way between outright ban and smoking everywhere.Patients on secure units who are detained are really struggling.They find a nurse offfering NRT condecending.
    To say the ban reduces aggression is poor propaganda

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