title: Smoking cessation care in state-operated or state-supported psychiatric hospitals: from policy to practice.
abstract: OBJECTIVE
  The aims of this study were to identify changes in smoking policies and their implementation and to determine the level of smoking cessation care provided at state-operated or state-supported psychiatric inpatient hospitals.
  
  
  METHODS
  Hospitals were surveyed in 2008 (N=219) and 2011 (N=206) about their smoking policies and practices, and changes in specific policies and practices, such as staff specialty training about smoking cessation care, assessment at intake, provision of smoking cessation treatment and education, and aftercare planning, were examined. Smoking cessation care was categorized as best, good, average, or poor.
  
  
  RESULTS
  The survey was completed in both 2008 and 2011 by 108 hospitals. The number of hospitals prohibiting smoking rose by 73%, from 48% in 2008 to 83% in 2011. The provision of specialty training to staff did not significantly improve. Nearly all hospitals assessed smoking status at admission, and nicotine replacement therapy was provided by more hospitals than any other treatment in both 2008 and 2011. The number of hospitals providing no follow-up of smoking cessation care after discharge dropped significantly, from 64% to 41%, and significantly more provided good versus average smoking cessation care.
  
  
  CONCLUSIONS
  Analysis of smoking policies at state-operated or state-supported psychiatric inpatient hospitals found significant movement in adopting nonsmoking policies and some increase in active treatment, notably wellness counseling. Educational resources have not reached full penetration, and continuum of care activities are also lagging behind. Additional resources and staff training may be needed to continue to address smoking cessation both during and after hospitalization.
authors.affiliation: National Association of State Mental Health Program, Directors Research Institute, Inc., 3141 Fairview Park Dr., Suite 650, Falls Church, VA 22042, USA. glorimar.ortiz@nri-inc.org
authors.forename: Glorimar
authors.initials: G
authors.lastname: Ortiz
authors.forename: Lucille
authors.initials: L
authors.lastname: Schacht
authors.forename: G Michael
authors.initials: GM
authors.lastname: Lane
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000639:trends; D000368:Aged; D002648:Child; D004812:Epidemiologic Methods; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000331:legislation & jurisprudence / Q000592:standards / Q000639:trends*; D006783:Hospitals, State / Q000331:legislation & jurisprudence / Q000592:standards / Q000639:trends*; D006801:Humans; D007318:Inservice Training / Q000639:trends; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D012017:Referral and Consultation / Q000639:trends; D061845:Smoke-Free Policy / Q000639:trends*; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D013038:Specialization; D061485:Tobacco Use Cessation Devices / Q000639:trends; D014481:United States / Q000453:epidemiology; D055815:Young Adult