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


Angela M. Hehir BAgSc, Dip Ed, BND, MPH, Evaluation Coordinator, Devon Indig BSc, MPH, PhD, Head of Research and Conjoint Senior Lecturer, Shani Prosser RN, RM, MA, Manager Health Advancement, Vicki A. Archer RN, BHA (Masters in Progress), Research Co-ordinator. Ms Angela M. Hehir, Centre for Health Research in Criminal Justice, Justice Health, Suite 302, Level 2, 152 Bunnerong Road, Pagewood, NSW 2035, Australia. Tel: +61 2 8372 3012; Fax: +61 2 9344 4151; E-mail: angela.hehir@justicehealth.nsw.gov.au


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.[Hehir AM, Indig D, Prosser S, Archer VA. Evaluation of a smoke-free forensic hospital: Patients' perspectives on issues and benefits. Drug Alcohol Rev 2012;31:672–677]