Evaluation of a smoke-free forensic hospital: patients' perspectives on issues and benefits

Abstract

Introduction and aims: In 2008, a new high secure forensic mental health inpatient hospital was opened in New South Wales as a smoke-free facility. This study describes the experience of patients and the impact of the smoke-free policy on smoking intentions and practice.

Design and methods: The study methods included: (1) four semi-structured focus groups with 21 current patients; (2) patient surveys collected from 45 current patients; and (3) follow-up survey from 15 discharged patients. All methods included questions related to smoking history, experience of moving to and living in the smoke-free environment and smoking intentions or status post discharge.

Results: Many focus group participants indicated that they were now off cigarettes for life while some were angry about the policy. Nearly all (80%) patients surveyed smoked prior to admission. Over one-third (39%) of patients were angry at being forced to stop smoking, while 42% wanted to give up when they were admitted. Most (62%) felt they had gained weight since they stopped smoking; however, 75% indicated that living in a smoke-free environment had a positive effect on their health. Over a third (36%) of patients indicated that they intended to smoke when discharged. Post discharge, of the 12 who smoked prior to admission, seven (58%) remained non-smokers at follow up.

Discussion and conclusions: This study describes promising findings about the experience of patients moving to a smoke-free mental health inpatient facility, including improved health and potential for sustained smoking cessation post discharge.