Objective: This paper reviews the findings from 26 international studies that report on the effectiveness of smoking bans in inpatient psychiatric settings. The main aim is to identify which proces...

/pdf/smoking-bans-in-psychiatric-inpatient-settings-a-review-of-2umf88hi6a.pdf

Smoking bans in psychiatric inpatient settings? A review of the research

OBJECTIVE: Despite high rates of tobacco use among psychiatric patients, such patients are one of the least studied groups of smokers, and little is known about their access to cessation treatment. This study examined delivery of tobacco cessation services in a smoke-free inpatient psychiatric setting. METHODS: Medical records of 250 psychiatric inpatients who were admitted from 1998 to 2001 were randomly selected and systematically reviewed. RESULTS: A total of 105 patients (42 percent) were identified as current smokers; the mean±SD number of cigarettes that they smoked per day was 21±15. Smokers evidenced statistically greater agitation and irritability compared with nonsmokers. None of the smokers received a diagnosis of nicotine dependence or withdrawal, and smoking status was not included in treatment planning for any patient. Nicotine replacement therapy was prescribed for 59 smokers (56 percent); of these patients, 54 (92 percent) used it. Smokers who were not given a prescription for nicotine rep...

https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.55.11.1265

Treatment of Tobacco Use in an Inpatient Psychiatric Setting

OBJECTIVE: Health care facilities are increasingly implementing policies that ban smoking. A concern has been raised that these policies may have a negative impact on smokers who are mentally ill or substance dependent. The authors conducted a literature review to analyze the relevant empirical evidence. METHODS: Major health care databases were searched. Major search terms included smoking, smoking cessation, nicotine, health policy, hospital policy, smoke-free policy, psychiatric disorders, and substance use disorders. The search was limited to empirical studies, which were analyzed on the basis of design, the behavioral indicators monitored, and the results of questionnaires. RESULTS AND CONCLUSIONS: A total of 22 investigations of the impact of total or partial smoking bans suggest that the policies have had no major longstanding untoward effect in terms of behavioral indicators of unrest or compliance. However, the policies appear to have had little or no effect on smoking cessation. Smoking cessatio...

https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.53.12.1617

Public Health and Therapeutic Aspects of Smoking Bans in Mental Health and Addiction Settings

Background: This article reports the findings from a comparative study investigating smoking behaviours among institutionalised psychiatric populations from a sociological perspective.Method: The study involved participant observation of two separate Australian sites between 1999 and 2002, the second site serving to generalise the findings from the first site.Discussion and conclusions: Systemic barriers to quitting were identified, emanating from the mental health system in general. Cigarettes were identified as the currency by which economic, social and political exchange took place between participants who described an enculturation process that involved complex processes of reinforcement to smoke. Once entered into, escape from the smoking culture of the settings appeared to be extremely difficult for clients and staff.

Systemic barriers to quitting smoking among institutionalised public mental health service populations: a comparison of two Australian sites.

Background
The introduction of total smoking bans represents an important step in addressing the smoking and physical health of people with mental illness. Despite evidence indicating the importance of staff support in the successful implementation of smoking bans, limited research has examined levels of staff support prior to the implementation of a ban in psychiatric settings, or factors that are associated with such support. This study aimed to examine the views of psychiatric inpatient hospital staff regarding the perceived benefits of and barriers to implementation of a successful total smoking ban in mental health services. Secondly, to examine the level of support among clinical and non-clinical staff for a total smoking ban. Thirdly, to examine the association between the benefits and barriers perceived by clinicians and their support for a total smoking ban in their unit.

/pdf/total-smoking-bans-in-psychiatric-inpatient-services-a-2db4dfuv4w.pdf

Total smoking bans in psychiatric inpatient services: a survey of perceived benefits, barriers and support among staff

The feasibility of smoking bans on psychiatric units.

horea is a dyskinesia or abnormal involuntary movement due to pathology of the basal ganglia, particularly the caudate nucleus. ChoreiC form movements are rapid, irregular muscular contractions. Chorea occurs in hereditary disorders such as Huntington disease, Wilson disease, ataxia telangiectasia, and Lesch Nyhan syndrome, or as a purported sequela of infection, such as in Sydenham chorea or chorea gravidarum. It can also occur after treatment with neuroleptics and other dopamine blocking agents.'S2 In the elderly, chorea most often occurs in an idiopathic form, senile chorea, or in association with cerebrovascular disease.* Senile chorea is characterized by choreiform movements, often buccolingual but sometimes generalized in older patient^.^,^ There is a gradual rather than abrupt onset of symptons, no intellectual deterioration, and no family history of early-onset ~h0rea. l .~ Two pathology cases studied by Alcock showed shrinkage and a reduced number of neurons in the putamen and caudate with sparing of the globus pallidus and cerebral cortex.6 Senile chorea has been treated with dopamine antagonists. These agents act via dopamine-receptor blockage or inhibition of dopamine uptake or storage. We report the first case to our knowledge of senile chorea successfully treated with sodium valproate.

Successful treatment of age-related chorea with sodium valproate.

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The feasibility of smoking bans on psychiatric units.

Successful treatment of age-related chorea with sodium valproate.