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Smoke-free policies in psychiatric services: identification of unmet needs
  1. Montse Ballbè1,2,
  2. Gemma Nieva3,
  3. Sílvia Mondon2,
  4. Cristina Pinet4,
  5. Eugeni Bruguera3,
  6. Esteve Saltó5,6,
  7. Esteve Fernández1,7,
  8. Antoni Gual2,
  9. and the Smoking and Mental Health Group*
  1. 1Catalan Network of Smoke-free Hospitals, Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
  2. 2Alcohol Unit, Department of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
  3. 3Addictive Behaviours Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
  4. 4Drug Dependence Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
  5. 5Public Health Department, Ministry of Health, Generalitat de Catalunya, Barcelona, Spain
  6. 6Department of Public Health, Universitat de Barcelona, Barcelona, Spain
  7. 7Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
  1. Correspondence to Dr Esteve Fernández, Unitat de Control del Tabaquisme, Programa de Prevenció i Control del Càncer, Institut Català d'Oncologia, Av. Gran Via de l'Hospitalet de Llobregat, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; efernandez{at}


Introduction Smoke-free policies have been extended to enclosed workplaces in many countries; however, smoking continues to be commonly allowed on psychiatric premises. The aim of this study was to describe tobacco control strategies undertaken in psychiatric inpatient services and day centres in Spain.

Methods This cross-sectional survey included all psychiatric service centres that offered public services in Catalonia, Spain (n=192). Managers responded to a questionnaire of 24 items that covered four dimensions, including clinical intervention, staff training and commitment, smoking area management and communication of smoke-free policies.

Results A total of 186 managers (96.9%) completed the questionnaire. Results showed low tobacco control in psychiatric services: 41.0% usually intervened in patient tobacco use, 34.1% had interventional pharmacotherapy available and 38.9% had indoor smoking areas. Day centres showed the lowest implementation of tobacco control measures. Out of 186 managers, 47.3% stated that the staff had insufficient knowledge on smoking cessation interventions.

Conclusions The former Spanish partial law has not been sufficiently successful in promoting tobacco control in psychiatric services. There is room for improvement in tobacco control policies, specifically in smoking interventions, staff training and resource availability.

  • Smoking
  • psychiatry
  • hospitals
  • delivery of healthcare
  • policy
  • secondhand smoke
  • addiction
  • cessation
  • public policy
  • smoking-caused disease
  • prevalence
  • environmental tobacco smoke
  • cessation

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  • * The group is also composed by: Dolors Agulló, Francesc Bleda, Margarita Cano, Margarita de Castro, Montserrat Contel, MaTeresa Delgado, Conxi Domínguez, Isabel Feria, Teresa Fernández, Francina Fonseca, Imma Grau, Rosa Hernández, Teodor Marcos, Isabel de María, Concepció Martí, Jordi Pagerols, Anna Pla, Antònia Raich, Maite Sanz, Teresa Sarmiento, Susana Subirà, Joan Viñas.

  • Funding This work was supported by the Thematic Network of Cooperative Research on Cancer (RD06/0020/0089) from the Instituto de Salud Carlos III, government of Spain, the Ministry of Universities and Research (2009SGR192) and the Directorate of Public Health, Ministry of Health (GFH 20051) from the government of Catalonia.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.