all psychiatric patients oppose smoking ban on units, study claims
by Angela Hussain
every patient opposes a total smoking ban inside mental health units,
according to research in one NHS trust.
findings published in this month's Psychiatric Bulletin journal
are likely to further the debate as to whether an outright ban of
smoking in psychiatric units is justified.
patients detained in Rampton top security hospital in Nottinghamshire
yesterday lost a high court test case for the right to continue
smoking. Judges ruled the ban was justified for "health and
is estimated that 70% of patients in psychiatric hospital smoke,
and 50% are heavy smokers. This compares with 25% and 9%, respectively,
In a survey of 135 inpatients on 13 mental health wards at Mersey
Care NHS Trust, just three per cent supported a complete smoking
ban inside and on hospital premises.
in ten (14%) thought there should be a complete ban inside only.
Seven in ten (71%) supported having designated smoking areas.
Smoking was banned last year in all enclosed public and work. A
exemption for mental health units ends on July 1. Until then, they
may continue to have a designated smoking room.
While 90% of the general public believe smoking should be banned
in public places, only 50% of the study's patients agreed.
Two years ago Kings Fund research found almost all mental health
nurses do not want smoking banned in psychiatric wards, often because
they fear that it would spark aggression from patients.
Smoking policy should be “more
lenient” in psychiatric units, argue the
authors of the Psychiatric Bulletin study.
Jennifer Smith and Charlotte O’Callaghan suggest
psychiatric units should either build external unenclosed smoking
shelters or an outdoor smoking area leading off from, and visible
from, wards. This would mean that patients deemed too ill to go
outside would still be viewable when smoking.
"The fact that this study showed a large difference between
those wanting a total smoking ban inside hospital buildings (14%)
and those supporting the government ban on smoking in public places
(54%) may reflect views that smoking policy should be more lenient
in psychiatric units,” wrote Drs
Smith and O’Callaghan.
acting for Rampton patients had argued that they would be the only
group of people in the country banned from smoking "in the
privacy of their home", because, unlike patients at other hospitals,
many were not allowed outdoors to smoke.
Paul Bowen said others whose homes are in public spaces, such as
soldiers and care home patients, will still be able to smoke under
Rampton patients face a total ban that amounts to unfair and unlawful
discrimination, he said.
patients were refused permission to appeal, but can still ask the
court of appeal itself to consider their case because of its important
judges also rejected allegations that the smoking ban, introduced
at Rampton in April last year by Nottinghamshire Healthcare NHS
Trust, was inflexible because no exemptions had been granted.
showed the ban was not having a de-stabilising effect on patients,
said the judges.
Justice Pill said: "There is very strong evidence that smoking
causes disease and endangers the health of the smokers themselves
and other people who live and work in their vicinity."
judge added the smoking ban was also justified by security difficulties
posed by allowing patients - many of whom have "dangerous,
violent or criminal propensities" - to smoke outside in Rampton's
other hospitals, it is smoke-free. Both health and security considerations
justify the ban even though smoking in the grounds, which may be
possible at other hospitals, is not feasible at Rampton," said
Lord Justice Pill in a decision made with Mr Justice Silber.
Patients can be detained at Rampton for years.
20, 2008: Psychiatric patients launch test case for right to smoke
while detained - patients could be only group of people banned
from smoking "in the privacy of their own home", judges
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