title: Implementation of a smoke-free policy in an inpatient psychiatric facility: Patient-reported adherence, support, and receipt of nicotine-dependence treatment.
abstract: The implementation of smoke-free policies in inpatient psychiatric facilities, including patient adherence, mental health nursing staff support, and provision of nicotine-dependence treatment to patients, has been reported to be poor. The extent to which the quality of smoke-free policy implementation is associated with patient views of a policy is unknown. We conducted a cross-sectional survey of 181 patients (53.6%, n = 97 smokers; and 46.4%, n = 84 non-smokers) in an Australian inpatient psychiatric facility with a total smoke-free policy. Smokers' adherence to the policy was poor (83.5% smoked). Only half (53.6%) perceived staff to be supportive of the policy. Most smokers used nicotine-replacement therapy (75.3%); although few received optimal nicotine-dependence treatment (19.6%). Overall, 45.9% of patients viewed the smoke-free policy in the unit as positive (29.9% smokers; 64.3% non-smokers). For smokers, adhering to the ban, perceiving staff to be supportive, and reporting that the nicotine-replacement therapy reduced cravings to smoke were associated with a more positive view towards the smoke-free policy. These findings support the importance of patient adherence, mental health nursing staff support, and adequate provision of nicotine-dependence treatment in strengthening smoke-free policy implementation in inpatient psychiatric settings.
authors.affiliation: University of Newcastle, University Drive, Callaghan, New South Wales (NSW), 2308, Australia.|Hunter Medical Research Institute (HMRI), Level 3 John Hunter Hospital, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.|National Drug and Alcohol Research Centre (NDARC), UNSW Australia, 22-32 King Street, Randwick, NSW, 2031, Australia.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Stockings
authors.affiliation: University of Newcastle, University Drive, Callaghan, New South Wales (NSW), 2308, Australia.|Hunter Medical Research Institute (HMRI), Level 3 John Hunter Hospital, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
authors.forename: Jenny A
authors.initials: JA
authors.lastname: Bowman
authors.affiliation: University of Newcastle, University Drive, Callaghan, New South Wales (NSW), 2308, Australia.|Hunter Medical Research Institute (HMRI), Level 3 John Hunter Hospital, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.|Hunter New England Population Health (HNEPH), Longworth Avenue, Wallsend, NSW, 2257, Australia.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Bartlem
authors.affiliation: University of Newcastle, University Drive, Callaghan, New South Wales (NSW), 2308, Australia.|Hunter Medical Research Institute (HMRI), Level 3 John Hunter Hospital, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.|Hunter New England Population Health (HNEPH), Longworth Avenue, Wallsend, NSW, 2257, Australia.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: McElwaine
authors.affiliation: University of Newcastle, University Drive, Callaghan, New South Wales (NSW), 2308, Australia.|Centre for Translational Neuroscience and Mental Health (CTNMH), Mater Hospital, Level 5 McAuley Building, Waratah, NSW, 2298, Australia.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Baker
authors.affiliation: Mental Health and Substance Use Service (MHSUS), Mater Hospital, Level 5 McAuley Building, Waratah, NSW, 2298, Australia.
authors.forename: Margarett
authors.initials: M
authors.lastname: Terry
authors.affiliation: University of Newcastle, University Drive, Callaghan, New South Wales (NSW), 2308, Australia.|Centre for Translational Neuroscience and Mental Health (CTNMH), Mater Hospital, Level 5 McAuley Building, Waratah, NSW, 2298, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Clancy
authors.affiliation: Hunter New England Population Health (HNEPH), Longworth Avenue, Wallsend, NSW, 2257, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Knight
authors.affiliation: University of Newcastle, University Drive, Callaghan, New South Wales (NSW), 2308, Australia.|Hunter Medical Research Institute (HMRI), Level 3 John Hunter Hospital, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.|Hunter New England Population Health (HNEPH), Longworth Avenue, Wallsend, NSW, 2257, Australia.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Wye
authors.affiliation: University of Newcastle, University Drive, Callaghan, New South Wales (NSW), 2308, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Colyvas
authors.affiliation: University of Newcastle, University Drive, Callaghan, New South Wales (NSW), 2308, Australia.|Hunter Medical Research Institute (HMRI), Level 3 John Hunter Hospital, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.|Hunter New England Population Health (HNEPH), Longworth Avenue, Wallsend, NSW, 2257, Australia.
authors.forename: John H
authors.initials: JH
authors.lastname: Wiggers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006778:Hospitals, Psychiatric / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D061845:Smoke-Free Policy; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D061485:Tobacco Use Cessation Devices; D055815:Young Adult
keywords: nicotine dependence; patient acceptance of health care; psychiatric department; smoke-free policy; smoking