Smoking Ban Implementation in Psychiatric Inpatient Hospitals: Update and Opportunity for Performance Improvement

Objectives: To determine the incidence and prevalence of smoking bans in psychiatric inpatient hospitals. To evaluate the differences between hospitals that prohibit and those that allow smoking on the identification of smoking risks, availability of educational resources, treatments offered, and documentation of the patients' smoking status in the continuing care plan. To identify opportunities for performance improvement for the psychiatric care provided to patients. Methods: A survey on smoking policies and practices was completed by 165 hospital directors and quality assurance managers. Cross-tabulation and frequency determined the incidence and prevalence of smoking bans. Chisquare analysis tested for differences between hospitals that prohibit and hospitals that allow smoking and the characteristics under study. Results: The incidence and prevalence rates of smoking bans were 70% and 79%, respectively. Significant differences between hospitals prohibiting and allowing smoking were found in the identification of smoking risks during formal screenings. Conclusion: The incidence and prevalence rates of smoking bans continue at an increased rate, as evidenced by more psychiatric hospitals enacting smoking bans and removing barriers to policy implementation. Psychiatric hospitals that have not adopted smoking bans may not be aware of their readiness to enact a formal tobacco-free policy, given their similarity to hospitals that prohibit smoking. However, hospitals included the patients' smoking status in the continuing care plan at a very similar low rate. Hospitals could maximize the reporting of the Hospital Based Inpatient Psychiatric Services (HBIPS) performance measure including patients' smoking status at discharge and treatments into the next level of care recommendations to heighten awareness of the risks for smoking and promote continuation of tobacco cessation treatments.