Mental Health Professionals’ Views on Smoke-Free Policy

The prevalence of smoking within the general population is in decline. However, the number of people with mental health issues who smoke remains high.

A recent study has examined mental health care practitioners approach to addressing smoking with their patients and the barriers they come up against.

36 MHP participated in focus groups that looked at the experiences of addressing smoking with mental health patients.

The following themes were identified on analysis:

  • Psychological capability: Despite most of the MHP completing mandatory many MHPs could not remember the content of this training and knowledge around alternative approaches to addressing smoking with patients was poor.
  • Physical opportunity: Discussions about smoking tend to be patient led and if the practitioners feel they have time. The majority of MHP working in the community commented on the challenge of supporting patients to stop smoking in the community where tobacco is readily available
  • Social opportunity: MHP discussed a loss of a shared activity between staff and patient. They described it creating a culture of secrecy and policing.
  • Automatic motivation: Many believed that mental health patients lack the motivation to stop as tobacco was considered to be one of the few pleasures in their lives.Many patients felt it was not mental health teams responsibility to help them quit smoking.
  • Reflective motivation: Some MHP commented that addressing smoking habits with the patient is not a high priority compared to some of the other issues they are supporting with. There is a reluctance for MHP to start ‘policing’ smoking behaviour.

Overall there needs to be further communication about the benefits of smoking harm reduction approaches, better referral processes and signposting to specialists and the incorporation of smoking cessation into other interventions.

Smith, McNeill, Kock, Shahab. "Exploring mental health professionals’ practice in relation to smoke-free policy within a mental health trust: a qualitative study using the COM-B model of behaviour",BMC Psychiatry (2019): 19:54
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