Deconstructing myths, building alliances: a networking model to enhance tobacco control in hospital mental health settings.
Life expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals -the early adopters- based on Rogers' theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals' awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings.
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, WHO Collaborating Center for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain; Catalan Network of Smoke-free Hospitals, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona - IDIBAPS, Barcelona, Spain. Electronic address: mballbe@iconcologia.net.
Montse
M
Ballbè
Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona - IDIBAPS, Barcelona, Spain.
Antoni
A
Gual
Addictive Behaviours Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Gemma
G
Nieva
Health Plan Directorate, Ministry of Health, Generalitat de Catalunya, Barcelona, Spain; Department of Public Health, Universitat de Barcelona, Barcelona, Spain.
Esteve
E
Saltó
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, WHO Collaborating Center for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain; Catalan Network of Smoke-free Hospitals, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Campus of Bellvitge, Universitat de Barcelona, Barcelona, Spain.
Esteve
E
Fernández
D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D008603:Mental Health; D061845:Smoke-Free Policy; D016540:Smoking Cessation; D000074606:Smoking Prevention / Q000379:methods* / Q000458:organization & administration; D013030:Spain
Hospitales; Hospitals; Hábito de fumar; Mental health services; Psiquiatría; Psychiatry; Public health; Salud pública; Servicios de salud mental; Smoking; Tabaco; Tobacco