Persistent High Smoking Prevalence in a Swiss Psychiatric Hospital between 2001 and 2020 despite Smoking Bans and Perspectives for Further Necessary Interventions
Smoking, as a major risk factor for non-communicable diseases (NCD), led
the World Health Organization (WHO) to recommend measures to decrease tobacco consumption.
Declines were observed for the general population in western countries. The
present work is a naturalistic observational study which assessed tobacco use
on 4 independent occasions for patients and staff in a Swiss public psychiatric
hospital between 2001 and 2020. High smoking prevalence was observed, varying
between 31% and 39% for staff and 66% and 74% for patients. Despite the
implementation of a partial and later a total indoor smoking ban, data showed
no decline of cigarette consumption between 2005 and 2020 among patients. These
observations are in line with literature showing high smoking rates and no
trend of a decline for people presenting with mental health disorders. This
study controlled for substance use disorder (SUD), known to be related to
higher nicotine dependence, and showed that smoking was not associated with
psychiatric diagnosis (mood or psychotic disorders). These elements lead to
recommend a global approach using smoking cessation strategies designed for all
patients receiving mental health care. Although the alarming state of the
tobacco epidemic for these persons is known and evidence-based strategies for
smoking cessation exist, implementation of interventions to reduce smoking
within mental health settings remains sorely lacking. This paper summarizes
smoking cessation interventions that should be used in psychiatry and puts
forward the necessity to develop strategies
for the large group of not (yet) motivated to quit smo-kers.
Tobacco consumption is a modifiable behavior and changes in mental healthcare
routines should allow important health related benefits for smo-kers
presenting with psychic disorders.
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