Moving towards smoke-free mental health services

Scotland's smoke-free legislation, introduced in March 2006, included an exemption for psychiatric hospitals. However, following the successful implementation of smoke-free laws in almost all other workplaces in Scotland, important questions have been raised about why mental health facilities should be excluded. This study aimed to explore a move towards mental health settings becoming smoke-free in Scotland by reviewing relevant literature, seeking the views of stakeholders and examining a number of case study hospitals who had recently or were in the process of going smoke-free. The study found that stakeholders were overwhelmingly in favour of moving towards smoke-free environments. Allowing smoking to continue in these settings when almost all other workplaces are smoke-free was perceived as reinforcing the stigma attached to mental health, exacerbating inequalities in health, damaging the health of mental health professionals and potentially contributing to staff recruitment problems. Evidence from the international literature and from the case studies suggested that smoke-free policies can be successfully implemented in mental health settings. This article discusses these findings and examines the factors that need to be considered if implementation is to be successful.