title: Implementation of a smoke-free policy in a high secure mental health inpatient facility: staff survey to describe experience and attitudes.
abstract: BACKGROUND
  In 2008, a new forensic hospital was opened as a totally smoke-free facility. This study describes the attitudes and experience of mental health professionals working in the high secure mental health facility three years after it was opened. It is part of a larger evaluation describing the experience of current and discharged hospital patients.
  
  
  METHODS
  Quantitative data was collected using a survey of hospital staff (N = 111) with a 50% response rate. The survey collected demographic and smoking data to describe staff responses to statements relating to hospital smoking policy, patient care and staff support.
  
  
  RESULTS
  Among staff surveyed, 13% were current smokers and 41% were ex-smokers (10% quit after commencing employment in the smoke-free hospital). Most (88%) preferred to work in a smoke-free environment, although this was significantly lower in smokers compared to non-smokers (39% vs. 95%). While most staff felt that the smoke-free environment had a positive impact on the health of patients (86%) and on themselves (79%), smokers were significantly less likely to agree. Just over half (57%) of staff surveyed agreed that patient care was easier in a totally smoke-free environment, although less smokers agreed compared to non-smokers. Staff who smoked were also significantly less likely to indicate they had sufficient support working in a smoke-free environment, compared to non-smokers (15% vs. 38%).
  
  
  CONCLUSIONS
  The staff surveyed supported the smoke-free workplace policy; most agreed that patient care was easier and that the policy did not lead to an increase in patient aggression. Implementation of a total smoking ban can result in positive health outcomes for patients and staff, and may influence some staff to quit. Staff who smoke have a less positive experience of the policy and require additional support.
authors.affiliation: Centre for Health Research in Criminal Justice, Justice and Forensic Mental Health Network-J&FMHN, Suite 302, Level 2, 152 Bunnerong Rd, Eastgardens, NSW 2036, Australia. Angela.Hehir@justicehealth.nsw.gov.au
authors.forename: Angela M
authors.initials: AM
authors.lastname: Hehir
authors.forename: Devon
authors.initials: D
authors.lastname: Indig
authors.forename: Shani
authors.initials: S
authors.lastname: Prosser
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Archer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006284:Health Plan Implementation; D006778:Hospitals, Psychiatric / Q000145:classification; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D009786:Occupational Health Services / Q000706:statistics & numerical data; D016134:Organizational Policy; D012907:Smoking / Q000331:legislation & jurisprudence*; D016540:Smoking Cessation / Q000331:legislation & jurisprudence / Q000523:psychology*; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000517:prevention & control; D000078329:Workforce; D017132:Workplace / Q000331:legislation & jurisprudence / Q000592:standards
chemical_list: D014028:Tobacco Smoke Pollution