No Smoking in Many Psych Hospitals

Smoking cessation in psychiatric hospitals has improved but still has a ways to go

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Many psychiatric hospitals have started helping patients quit smoking, which is terrific. But the same hospitals may not be preparing patients to remain smoke-free when they go home.

In a recent study, researchers looked at the smoking policies and smoking cessation efforts of state-funded psychiatric hospitals in 2008 and 2011.

The results showed no-smoking policies and smoking cessation efforts have increased at the hospitals, but greater efforts to support smoking cessation after patients return home are needed.

"Don’t light up after hospital discharge."

Glorimar Ortiz, MS, from the National Association of State Mental Health Program Directors Research Institute in Falls Church, VA, led an investigation into how smoking cessation has been working in state-funded psychiatric hospitals.

“Tobacco use continues to be the leading cause of preventable death in the United States and is a major public health issue…This problem is heightened among individuals with psychiatric disorders, who are about twice as likely to smoke tobacco and who are heavier smokers compared with the general population,” said the authors.

For this study, 164 hospitals completed surveys in 2008 and 165 completed surveys in 2011 about their smoking policies and smoking cessation efforts.

A total of 108 of the hospitals answered the survey questions in both 2008 and 2011. The 108 hospitals were from 35 states and the District of Columbia.

In 2008, only 52 of the 108 hospitals allowed smoking on the facility grounds. In 2011, only 18 of the 108 hospitals still allowed smoking on the facility grounds

Most of the hospitals that still allowed smoking required smokers to use designated smoking areas, have staff escorts and only allowed them to smoke at certain times.

In 2008, a total of 61 percent of the hospitals provided smoking cessation training for their hospital staff, which increased to 65 percent by 2011.

Smokeless tobacco products were not allowed by 77 percent of hospitals in 2008 and 91 percent in 2011. Tobacco products were not sold on the grounds at 80 percent of hospitals in 2008 and 96 percent in 2011.

Smoking cessation efforts to help patients maintain a smoke-free lifestyle after leaving the hospital were used by only 20 percent of hospitals in 2011.

Smoking cessation counseling was offered by 60 percent of hospitals in 2008 and 78 percent in 2011. Nicotine replacement therapies, such as nicotine patches or nicotine gum, were offered by 87 percent of hospitals in 2008 and 90 percent in 2011.

Prescription medication for smoking cessation was offered by 55 percent of hospitals in 2008 and 65 percent in 2011. Prescription medication for smoking cessation may not be widely appropriate for patients taking other medications in mental health institutions.

The authors said hospitals using designated smoking times may be encouraging smoking through time triggers. Hospitals that use staff escorts to designated smoking areas require their staff to undergo secondhand smoke exposure evaluation.

“Although there was a marked increase in nonsmoking policies, there was no significant increase in the proportion of hospitals providing overall training to staff related to smoking cessation care,” the authors said.

“Additional resources and staff training may be needed to continue to address smoking cessation both during and after hospitalization,” the authors concluded.

This study was published in April in Psychiatric Services.

The University of San Francisco’s Smoking Cessation Leadership Center provided funding for this project. No conflicts of interest were found.

Reviewed by: 
Review Date: 
April 7, 2013
Last Updated:
April 10, 2013