Banning smoking for psychiatric patients

[Bjo]

OUr hospital has been non-smoking inside the facility for a long time. Starting in July, the patients will no longer be able to go outside to smoke. That means that for the last several months, they have been limiting the amount of cigarettes the patients can smoke.

Once the patients earn levels, they can go outside on privileges and they take their cigarettes with them. Depending on the restriction of the level, they can be outside quite a few times during the day.

My question is, does anyone have experience with long term forensic patients being forced to quit smoking altogether? I have read several articles that it can affect the levels of the psychotropic medication as well as trigger a depressive setback.

Any feedback would be greatly appreciated. I am on a recovery awareness committee and I am trying to come up with some information to take with me to the next meeting.

The patients have wanted to file grievances with the patient advocate but he has told them that smoking is not a right that they can grieve.

[Felixa]

Just a little update from my Trust's smoking ban. My unit went 'smoke-free' in August.

In practice it has not been particularly smoke-free. The smoke room has been locked off, but patients are allowed to smoke in the ward garden if they wish, or out on leave if they have it/use it.

While the weather has been warm, we have been having the garden open most of the time, but now it is beginning to cool down, the garden is just open for set times - about once an hour for 15 minutes. Most patients have reacted remarkably well, although one is a bit irritable about it, and is (understandably!) annoyed if we are a bit late about opening the door on time.

We have offered people support to stop, but only one guy on my ward took up the offer, and he was back on the cigarrettes within a day or too - smoking his usual but with added nicotine from his arm-patch!

The upside of people smoking supervised in the garden is that non-smoking nurses can have more interaction with the patients than when they just stayed in the smoke room all day. The downside is that there are adverse health effects on some of the staff. An asthmatic member of staff has noticed her asthma getting worse, and there is a pregnant member of staff who has to be careful about when she is in the garden or the common room leading onto it.

But so far, so good. We shall see during the winter months whether that has any effect on smoking behaviour.

Side-note: in our 'smoking cessation' training, they told us that certain anti-psychotics are hindered by nicotine, notably Clozapine. A lot of guys in our unit are on Clozapine, so this could be an attraction to giving up, and something to be aware of if people's smoking behaviour reduces.

Will keep you posted

Felixa