Time to Smoke: Facilitating Smoking Breaks in Mental Health Inpatient Settings: Table 1.

Robson, Deborah; Yates, Mary; Craig, Tom; McNeill, Ann

doi:10.1093/ntr/ntw103

Cited by 13 publications

(11 citation statements)

References 17 publications

(11 reference statements)

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“…20 The method allows the incidence of an outcome after policy introduction to be compared to that beforehand, whilst filtering out the effect of any underlying temporal or seasonal changes or variations in other potentially confounding variables. 21 For example, people with schizophrenia are more likely to perpetrate violence on in patient units compared to other patients, 7 and so fewer schizophrenia admissions in a given month may result in a lower rate of violence.…”

Section: Methodsmentioning

confidence: 99%

Effect of implementation of a smoke-free policy on physical violence in a psychiatric inpatient setting: an interrupted time series analysis

Robson

Spaducci

McNeill

et al. 2017

The Lancet Psychiatry

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(2017) Effect of implementation of a smoke-free policy on physical violence in a psychiatric inpatient setting: an interrupted time series analysis. Lancet Psychiatry, 4 (7). pp. 540-546. ISSN 2215-0374 Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/44243/1/The%20effect%20of%20implementing%20a %20smoke-free%20policy%20on%20physical%20violence%20within%20a%20psychiatric %20inpatient%20settingaccepted_version.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the Creative Commons Attribution Non-commercial No Derivatives licence and may be reused according to the conditions of the licence. For more details see: http://creativecommons.org/licenses/by-nc-nd/2.5/ A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.

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Section: Methodsmentioning

confidence: 99%

Effect of implementation of a smoke-free policy on physical violence in a psychiatric inpatient setting: an interrupted time series analysis

Robson

Spaducci

McNeill

et al. 2017

The Lancet Psychiatry

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“…Designated smoking breaks were routine in this organization during the indoor-only smoke-free policy period where patients congregated in confined outdoor spaces every 1-2 hours for an average of 19 min at a time to smoke (Robson et al 2016). Environments associated with smoking or visual imagery of smoking materials can be a cue to smoke or elicit cravings to smoke (Wray et al 2011;Conklin et al 2008).…”

Section: Discussionmentioning

confidence: 99%

“…Patients who smoked had access to nicotine replacement therapy (NRT). During this period, staff were spending approximately two hours and 23 min a day supervising smoking breaks (Robson et al 2016). Following the publication of The National Institute for Health and Care Excellence (2013) recommendations, a comprehensive smoke-free policy was introduced from 1 October 2014.…”

Section: Settingmentioning

confidence: 99%

Smoking‐related violence in a mental health setting following the implementation of a comprehensive smoke‐free policy: A content analysis of incident reports

Spaducci

McNeill

Hubbard

et al. 2019

Int J Mental Health Nurs

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Smoke‐free policies in mental health settings are important to protect health but are often impeded by staff concerns that physical violence may increase. We aimed to address the literature gap about the frequency, nature, and management of physical violence in relation to smoking. We compared the antecedents and containment of smoking‐related incidents of physical violence over a two‐year period, (12 months when an indoor‐only smoke‐free policy was in place, followed by 12 months after a new comprehensive smoke‐free policy was introduced) using incident reports completed by staff in a large mental health organization in London, UK. Sixty‐one smoking‐related incidents occurred during the indoor‐only smoke‐free policy period; 32 smoking‐related incidents occurred during the comprehensive smoke‐free policy. We identified four antecedent categories for physical violence: i) patient request to smoke denied by staff; ii) during a supervised smoking break; iii) staff response to a patient breach of the smoke‐free policy iv) asking for, trading or stealing smoking materials. The antecedent pattern changed across the two policy periods, with fewer incidents of denying a patient's request to smoke and a greater number of incidents involving staff responding to breaches occurring after the introduction of the comprehensive smoke‐free policy. The prohibition of smoking breaks removed this source of violence. Timeout and PRN medication were the most common containment interventions. Understanding the context of smoking‐related violence may inform clinical guidelines about its prevention and management.

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“…The 'right' to smoke- (9,11) Smoking as self-medication, helps with coping (6) Smoking breaks are acceptable - (9,(34)(35)(36) Quitting increases violence- (11,37) Not the responsibility of MH staff to support patients to quit - (5,9).…”

Section: Threats To Normalizationmentioning

confidence: 99%

Supporting mental health service users to stop smoking: findings from a mixed method evaluation of the implementation of nicotine management policies into two mental health trusts

Jones

Billett

Mulrine

et al. 2020

Preprint

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Background Life expectancy is 10-20 years lower among people with a severe mental health disorder. Most of these early deaths are due to chronic conditions, including cardiovascular and respiratory diseases. Smoking is a major risk factor for these conditions and introducing nicotine management policies has been recommended to mental health service providers. This paper reports an evaluation of introducing these policy recommendations. Aim To reflect on the process and effectiveness outcomes when introducing nicotine management policies, including smokefree sites, in National Health Service (NHS) Trusts providing mental health services in an English region. Method Process data were collected through semi-structured interviews with staff (n=51), members of partnering organisations (n=5), service users (n=7) and carers (n=2) between November 2016–April 2017. Normalization Process Theory (NPT) was used to design the data collection tools and analyse the data. A framework approach was taken with the analysis using the four concepts of NPT: coherence, cognitive participation, collective action and reflexive monitoring. Aggregate routine quantitative data indicating the smoking status of service users were collected by querying patient administration systems every other quarter between 2013 and 2017. The data were analysed to investigate quality and completeness and to monitor smoking prevalence among service users over time. Results The policy made sense to some staff (coherence) who ‘bought-into’ the idea (cognitive participation) but other staff disagreed. Although nicotine management interventions were operationalised (collective action), sometimes they were opposed. Progress was made, especially in some units, but continued to be resisted in others. Informal appraisal of progress (reflexive monitoring) presented a varied picture. Routinely collected numerical data were of limited quality due to the high proportion of missing values; although there was some evidence of reducing smoking prevalence in both Trusts. Conclusion Some progress has been made in terms of changing entrenched, smoking cultures into one that is smokefree on Trust sites across the region. Systems for accurate, routine data capture of continued smoking and stop smoking journeys need to be established. Perseverance and resourcing over the long-term is required to establish routine data capture and a non-smoking culture in on-site provision of mental health services.

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Time to Smoke: Facilitating Smoking Breaks in Mental Health Inpatient Settings: Table 1.

Cited by 13 publications

References 17 publications

Effect of implementation of a smoke-free policy on physical violence in a psychiatric inpatient setting: an interrupted time series analysis

Effect of implementation of a smoke-free policy on physical violence in a psychiatric inpatient setting: an interrupted time series analysis

Smoking‐related violence in a mental health setting following the implementation of a comprehensive smoke‐free policy: A content analysis of incident reports

Supporting mental health service users to stop smoking: findings from a mixed method evaluation of the implementation of nicotine management policies into two mental health trusts

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