| Description |
Tobacco is the only legal drug that kills many of its users when used exactly as directed by the manufacturers. Tobacco use is the leading cause of preventable death and disability in the world and there is approximately one death every six seconds caused by tobacco use and exposure to tobacco smoke (WHO, 2012). The consequences of tobacco dependence are the leading causes of death in persons with mental health and addictive disorders (MHA). Those persons who suffer from MHA smoke more heavily, for longer periods of time, and prefer higher-tar cigarettes when compared to smokers in the general population (Moss et al., 2010). MHA smokers are thus at a higher risk for tobacco-related diseases such as cardiovascular illness, respiratory disease and cancer. Moss et al. (2010) stated: The prevalence of smoking among individuals with MHA disorders exceeds those in the general population by 2-4 fold. In patients with depressive and anxiety disorders, smoking rates range from 40 - 50%, and as high as 70-90% in patients with chronic schizophrenia. Individuals with MHA disorders account for a substantial proportion (up to 50%) of cigarettes sold in the United States, which is estimated to be approximately $180 billion in tobacco industry sales annually (p. 294). Prohibiting lethal substance use/abuse is almost a universal rule on inpatient mental health settings-with the exception of tobacco use. According to Williams (2008), "Programs that treat behavioral health problems… are the only remaining sector of health care that fail to systematically help patients quit smoking" (p. 573). Through this failure many inpatient mental health facilities continue to condone and even inadvertently promote tobacco use. This paper attempts to answer the following question: Should inpatient mental health and addiction treatment facilities be tobacco-free? To accomplish this, a search was conducted to identify meta-analyses, reviews and individual studies. The electronic databases PUBMED, MEDLINE, CINAHL, PSYCHINFO, were searched, covering 1980 to 2013, using the terms smoking, tobacco, inpatient, hospital, psychiatric, mental disorders, nursing, full ban and total ban. Study inclusion criteria were: complete tobacco ban, human subjects, inpatient setting, and psychiatric inpatient setting. Study exclusion criteria were: partial tobacco ban. I also will refer to studies referenced in articles of interest to contribute to discussion and conclusions. |
