Open Access Open Badges Research article

Implementation of a smoke-free policy in a high secure mental health inpatient facility: staff survey to describe experience and attitudes

Angela M Hehir1*, Devon Indig2, Shani Prosser3 and Vicki A Archer4

Author Affiliations

1 Centre for Health Research in Criminal Justice, Justice and Forensic Mental Health Network (J&FMHN), Suite 302, Level 2, 152 Bunnerong Rd, Eastgardens, NSW, 2036, Australia

2 School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, 2052, Australia

3 J&FMHN, 1300 Anzac Parade, Malabar, NSW, 2036, Australia

4 J&FMHN, Suite 302, Level 2, 152 Bunnerong Rd, Eastgardens, NSW, 2036, Australia

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BMC Public Health 2013, 13:315  doi:10.1186/1471-2458-13-315

Published: 8 April 2013



In 2008, a new forensic hospital was opened as a totally smoke-free facility. This study describes the attitudes and experience of mental health professionals working in the high secure mental health facility three years after it was opened. It is part of a larger evaluation describing the experience of current and discharged hospital patients.


Quantitative data was collected using a survey of hospital staff (Nā€‰=ā€‰111) with a 50% response rate. The survey collected demographic and smoking data to describe staff responses to statements relating to hospital smoking policy, patient care and staff support.


Among staff surveyed, 13% were current smokers and 41% were ex-smokers (10% quit after commencing employment in the smoke-free hospital). Most (88%) preferred to work in a smoke-free environment, although this was significantly lower in smokers compared to non-smokers (39% vs. 95%). While most staff felt that the smoke-free environment had a positive impact on the health of patients (86%) and on themselves (79%), smokers were significantly less likely to agree. Just over half (57%) of staff surveyed agreed that patient care was easier in a totally smoke-free environment, although less smokers agreed compared to non-smokers. Staff who smoked were also significantly less likely to indicate they had sufficient support working in a smoke-free environment, compared to non-smokers (15% vs. 38%).


The staff surveyed supported the smoke-free workplace policy; most agreed that patient care was easier and that the policy did not lead to an increase in patient aggression. Implementation of a total smoking ban can result in positive health outcomes for patients and staff, and may influence some staff to quit. Staff who smoke have a less positive experience of the policy and require additional support.

Smoke-free policy; Psychiatric hospital; Staff; Attitudes; Smoking