title: Becoming tobacco-free: Changes in staff and patient attitudes and incident reports in a large academic mental health and addictions hospital.
abstract: OBJECTIVE
  Complete tobacco bans in mental health facilities are thought to have the potential for adverse consequences. We evaluated staff and patient attitudes and adverse events associated with implementing Canada's largest, multi-site academic psychiatric hospital tobacco ban.
  
  
  METHODS
  A total of 1,173 staff and 422 patients completed an anonymous attitudes survey at prior to implementation (baseline), and 4-6 months and 10-12 months post-implementation. The tobacco-free initiative was implemented in a phased approach, allowing the prospective measurement of changes in attitudes and adverse outcomes such as agitation over a 1-year period.
  
  
  RESULTS
  We observed positive changes in staff and patient attitudes toward the tobacco-free policy for both staff and patients. Moreover, there was also a statistically significant decrease in patient agitation F (2, 99) = 3.25, p = .04, but no change F (2, 21) = 1.09, p = .35 in fire-related incidents.
  
  
  CONCLUSIONS
  We observed positive changes in staff and patients attitudes and significant decrease in patient agitation during the first year of this tobacco-free hospital initiative.
  
  
  CONCLUSIONS
  During the first year of this tobacco-free psychiatric hospital policy, implementation of a tobacco-free environment in a large mental health and addictions setting was feasible and perceived as desirable by the majority of staff and patients surveyed and a decrease in incidents related to patient agitation was also observed. Further well-controlled studies with longer study durations are warranted. (Am J Addict 2017;26:183-191).
authors.affiliation: Center for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Lilian
authors.initials: L
authors.lastname: Riad-Allen
authors.affiliation: Center for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Sarah Siodmok
authors.initials: SS
authors.lastname: Dermody
authors.affiliation: Center for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Yarissa
authors.initials: Y
authors.lastname: Herman
authors.affiliation: Center for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Kim
authors.initials: K
authors.lastname: Bellissimo
authors.affiliation: Center for Addiction and Mental Health, Toronto, Ontario, Canada.|Departments of Family and Community Medicine, Psychiatry and Dalla Lana School of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Selby
authors.affiliation: Center for Addiction and Mental Health, Toronto, Ontario, Canada.|Divison of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Tony Peter
authors.initials: TP
authors.lastname: George
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016739:Behavior, Addictive / Q000523:psychology / Q000534:rehabilitation; D002170:Canada; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006778:Hospitals, Psychiatric / Q000592:standards*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D016134:Organizational Policy; D011446:Prospective Studies; D012907:Smoking / Q000523:psychology / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000517:prevention & control
chemical_list: D014028:Tobacco Smoke Pollution