Staff smoking levels hamper success of smoke-free policies

Staff smoking levels have an impact on the success of smoke-free policies in psychiatric units, an Australian study has found. The study of almost 100 adult psychiatric inpatient settings also found that sufficient preparation time, availability and effective use of nicotine replacement therapy, good leadership, cohesive team work and extensive education and training were associated with more successful smoke-free policy implementation. Writing in Psychiatric Services the study authors from the Department of Psychiatry at Flinders University, Adelaide said their study builds on previous research from the UK and USA but is the first in Australia to undertake a national consultation with inpatient psychiatric units to clarify factors associated with the success or failure of implementing smoke-free initiatives. Dr Sharon Lawn, from Flinders University and Dr Jonathan Campion of the Division of Mental Health, St George’s University of London, UK, conducted semi-structured in-depth telephone interviews with 60 senior administrators and clinical staff with direct experience of smoking activities in almost 100 adult psychiatric inpatient settings ( 56 open units and 43 locked) around Australia. They found that 95% of smoke-free units reported staff smoking rates of 19% or less, whereas 86% of units where smoke free policies had failed reported staff smoking rates of 30% and above. Participants from smoke-free units also reported that reducing staff smoking had been prioritised in the months before initiating a transition. Furthermore, 92% of smoke–free units reported standard or extensive staff education and training related to smoking and mental illness, cohesive teamwork and good leadership. Results also showed that units that took more than six months to prepare and plan for the transition were more likely to successfully implement a smoke-free policy than units taking less than 6 months. The authors concluded that investment in staff training and education appears essential to shifting smoking culture within psychiatric inpatient units....