Monday 22 June 2009
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Respondents to survey of psychiatric wards say only a minority
have implemented the ban on smoking in enclosed spaces wholly
successfully
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Widespread problems with practicalities of ban, leading to
reported rise in ‘secret smoking’, safety concerns and staff
dissatisfaction with policing role
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Department of Health should carry out a formal assessment of the ban’s impact, says charity
A survey has uncovered widespread problems with the implementation
of the smoking ban in psychiatric units in England. The Mental Health
Foundation has published the results today in its report, <%$Linker: Asset 1 73083 0 oLinkAssetPdf <strong>Death of the smoking den</strong> Death of the smoking den report /EasySiteWeb/GatewayLink.aspx?alId=73083 true false%>: The initial impact of no smoking legislation in England in 2008.
A large majority (85%) of respondents to the survey said that the
ban, which came into effect on 1 July 2008, had been implemented only
partially - or not at all - effectively.
Respondents also indicated that many practical problems arising from
the ban’s implementation were going unaddressed. In particular,
respondents reported a rise in ‘secret smoking’ and occasions where
staff feel the need to turn a blind eye, particularly when patients are
very unwell. The report argues this could mean that both patients and
staff are breaking the law.
The survey highlighted problems caused in many units by the lack of
a safe outdoor space where patients can smoke. Even where such a
space existed, respondents reported that the need to escort patients
outside to smoke was a considerable drain on staff time and resources.
Respondents also reported feeling uncomfortable with their
enforcement role, especially where patients had no opportunity to smoke
outside. Some staff reported feeling more like police than nurses;
others cited incidents of aggression linked to the no smoking policy.
Many staff also raised concerns about the possible fire risks presented
by covert smoking and disposal of cigarette butts.
Simon Lawton-Smith, Head of Policy at the Mental Health Foundation and the report’s author, 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.
Where access to an outside space is limited or unavailable, staff
seem to be in the difficult position of either risking breaking the law
by turning a blind eye, or denying a patient the right to smoke
completely. This sits uncomfortably with the idea of patient choice.”
The report says that where successful, the implementation of the ban
was helped by the widespread consultation of staff and patients before
the ban came into affect, and the sufficient provision of
smoking cessation support such as Nicotine Replacement Therapy and
alternative activities for patients.
Death of the smoking den recommends that the National Mental Health
Development Unit (NMHDU) leads on gathering and disseminating good
practice from successful units. The report also calls for a formal
review of the impact of the ban by the Department of Health that should
look at the effectiveness of the ban’s implementation and also assess
the benefits for staff and patients, smokers and non-smokers, given
that the ban was originally justified on public health grounds.
The Mental Health Foundation also published Taking a deep breath: the mental health implications of anti-smoking legislation in July 2007.
Notes for editors:
The survey for Death of the smoking den was carried out in the
autumn of 2008. A questionnaire was circulated through the National
Acute Care Mental Health Programme Steering Group and the National
Association of Psychiatric Intensive Care Units - 109 responses were
received from psychiatric units across England.
The total ban on smoking in mental health units came into effect on 1 July 2008.
For more information please contact the Mental Health Foundation press office on 020 020 7803 1130/28 or email sloveland@mhf.org.uk
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from and prevent mental health problems. We work to influence policy,
including government at the highest levels. And we use our knowledge to
raise awareness and to help tackle the stigma attached to mental
illness.
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