Mental healthcare staff experiences of Smokefree policy and suggestions for better support

First published: 09 May 2019 | Last updated: 20 May 2019

PhD student

Background In England, smoking prevalence has declined to 15%; however, among patients hospitalised for mental health problems, smoking prevalence can reach up to 80%. In 2015, one of the largest providers of mental health services in England, South London and Maudsley (SLaM) NHS Foundation Trust implemented Smokefree policy which prohibited smoking in all Trust premises including grounds; this created an opportunity for inpatients to quit smoking with evidence-based support from staff. We tested the feasibility of providing additional support for mental health inpatients not to smoke once allowed on escorted leave from a ward and aimed to learn more from staff about the implementation and challenges related with Smokefree policy at SLaM.

Methods Semi-structured interviews with 11 staff members from three secure mental health wards within SLaM were analysed using thematic analysis. Participants were asked about views and experiences with the implementation of Smokefree policy and their perspectives on how better to support patients to remain smokefree.

Findings The transition to Smokefree policy was easier than staff anticipated but the policy received polarised views. Although nicotine replacement and e-cigarettes helped patients to cope with cravings, members of staff appreciated additional support, particularly CO monitoring and non-monetary rewards. Participants also highlighted that education, patients’ personal commitment not to smoke and continued support after hospitalisation could further increase patients’ chances to extend abstinence gained on a ward.

Conclusions Mental healthcare staff are willing to help smokers to abstain from smoking but further improvements in the policy and support options are needed.


Samara Wilson, DClinPsych, King’s College London Leonie Brose, PhD, King’s College London

Conflicts of interest:



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