Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England

Introduction: Despite high smoking prevalence and excessive smoking-related morbidity and mortality among people with mental disorder compared to the general population, smoking treatment is often neglected in mental health settings. The UK National Institute of Health and Clinical Excellence (NICE)...

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Main Authors: Sohal, Harpreet, Huddlestone, Lisa, Ratschen, Elena
Format: Article
Published: MDPI 2016
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Online Access:https://eprints.nottingham.ac.uk/39743/
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author Sohal, Harpreet
Huddlestone, Lisa
Ratschen, Elena
author_facet Sohal, Harpreet
Huddlestone, Lisa
Ratschen, Elena
author_sort Sohal, Harpreet
building Nottingham Research Data Repository
collection Online Access
description Introduction: Despite high smoking prevalence and excessive smoking-related morbidity and mortality among people with mental disorder compared to the general population, smoking treatment is often neglected in mental health settings. The UK National Institute of Health and Clinical Excellence (NICE) recently issued public health guidance stipulating completely smoke-free mental health settings. This project evaluated existing smoking-related practices in preparation for guidance implementation. The objectives were to: audit the recording of smoking-related information and treatment provision; explore current arrangements relating to the facilitation of patient smoking; measure staff time spent and identify costs of facilitating smoking; and explore the role of smoking in smoking-related incidents. Methods: A mixed-methods study was conducted across four acute adult mental health wards, accommodating 16 patients each, over six months. It included a case-note audit, on-site observations, and a qualitative content analysis of incident reports. Results: Smoking status was recorded for less than half of the 290 patients admitted (138, 48%). Of those, 98 (71%) were recorded as current smokers, of whom 72 (74%) had received brief smoking cessation advice. Staff spent 6028 h facilitating smoking, representing an annual cost of £131,040 across four wards. Incident reports demonstrated that smoking facilitation was often central to the cause of incidences, triggered frustration in patients, and strained staff resources. Conclusion: The findings highlight the importance and potential of implementing completely smoke-free policies using comprehensive pathways.
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spelling nottingham-397432020-05-04T17:35:42Z https://eprints.nottingham.ac.uk/39743/ Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England Sohal, Harpreet Huddlestone, Lisa Ratschen, Elena Introduction: Despite high smoking prevalence and excessive smoking-related morbidity and mortality among people with mental disorder compared to the general population, smoking treatment is often neglected in mental health settings. The UK National Institute of Health and Clinical Excellence (NICE) recently issued public health guidance stipulating completely smoke-free mental health settings. This project evaluated existing smoking-related practices in preparation for guidance implementation. The objectives were to: audit the recording of smoking-related information and treatment provision; explore current arrangements relating to the facilitation of patient smoking; measure staff time spent and identify costs of facilitating smoking; and explore the role of smoking in smoking-related incidents. Methods: A mixed-methods study was conducted across four acute adult mental health wards, accommodating 16 patients each, over six months. It included a case-note audit, on-site observations, and a qualitative content analysis of incident reports. Results: Smoking status was recorded for less than half of the 290 patients admitted (138, 48%). Of those, 98 (71%) were recorded as current smokers, of whom 72 (74%) had received brief smoking cessation advice. Staff spent 6028 h facilitating smoking, representing an annual cost of £131,040 across four wards. Incident reports demonstrated that smoking facilitation was often central to the cause of incidences, triggered frustration in patients, and strained staff resources. Conclusion: The findings highlight the importance and potential of implementing completely smoke-free policies using comprehensive pathways. MDPI 2016-02-25 Article PeerReviewed Sohal, Harpreet, Huddlestone, Lisa and Ratschen, Elena (2016) Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England. International Journal of Environmental Research and Public Health, 13 (3). p. 256. ISSN 1660-4601 Smoking; Mental health; Mental disorder; Tobacco dependence; Psychiatric settings; NICE PH48; Smoking cessation; Nicotine dependence; Smoke-free policy http://www.mdpi.com/1660-4601/13/3/256 doi:10.3390/ijerph13030256 doi:10.3390/ijerph13030256
spellingShingle Smoking; Mental health; Mental disorder; Tobacco dependence; Psychiatric settings; NICE PH48; Smoking cessation; Nicotine dependence; Smoke-free policy
Sohal, Harpreet
Huddlestone, Lisa
Ratschen, Elena
Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England
title Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England
title_full Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England
title_fullStr Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England
title_full_unstemmed Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England
title_short Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England
title_sort preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in england
topic Smoking; Mental health; Mental disorder; Tobacco dependence; Psychiatric settings; NICE PH48; Smoking cessation; Nicotine dependence; Smoke-free policy
url https://eprints.nottingham.ac.uk/39743/
https://eprints.nottingham.ac.uk/39743/
https://eprints.nottingham.ac.uk/39743/