Impact of a smoke-free policy in a large psychiatric hospital on staff attitudes and patient behavior.
OBJECTIVE
The objectives of this work were to examine changes over time in degree of staff support for the implementation of a smoke-free policy in Canada's largest public mental health and addiction teaching hospital and to assess the impact of the policy on patient behavior.


METHODS
Staff completed an anonymous survey, which assessed views toward the smoke-free policy and perceived change in patient behavior, 2-7 and 31-33 months after an indoor smoke-free policy was implemented (September 21, 2005). Objective indicators of patient behavior were also collected in the form of number of emergency code whites (aggressive behavior) and that of code reds (fire) called 1 year prior to and 2 years following policy implementation.


RESULTS
Survey response rates were 19.0% (n=481) and 18.1% (n=500) at 2-7 and 31-33 months, respectively. The proportion of staff who supported the policy increased from pre-implementation (82.6%) to post-implementation (89.1%), and a high level of support was maintained 2 years after policy enactment (90.1%). The number of emergency codes did not significantly change after policy implementation, and staff did not perceive a change in most forms of patient behavior.


CONCLUSIONS
A smoke-free policy can be implemented in a large psychiatric hospital with a high degree of support from staff and no substantial negative impact on patient behavior.
Centre for Addiction and Mental Health, Toronto, Canada M5S 2S1.
Sabrina
S
Voci
Susan
S
Bondy
Laurie
L
Zawertailo
Louise
L
Walker
Tony P
TP
George
Peter
P
Selby
D000328:Adult; D000374:Aggression / Q000523:psychology; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D003625:Data Collection; D005260:Female; D005390:Fires / Q000706:statistics & numerical data; D006284:Health Plan Implementation / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D016134:Organizational Policy; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010356:Patient Isolation / Q000706:statistics & numerical data; D012149:Restraint, Physical / Q000706:statistics & numerical data; D012907:Smoking / Q000331:legislation & jurisprudence* / Q000523:psychology; D016540:Smoking Cessation / Q000331:legislation & jurisprudence* / Q000523:psychology*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence* / Q000517:prevention & control*
D014028:Tobacco Smoke Pollution