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Tob Control. 2015 Oct;24(e3):e212-20. doi: 10.1136/tobaccocontrol-2014-051585. Epub 2014 Sep 19.

Secondhand smoke in psychiatric units: patient and staff misperceptions.

Author information

1
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain Catalan Network of Smoke-free Hospitals, L'Hospitalet de Llobregat, Barcelona, Spain Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona-IDIBAPS, Barcelona, Spain Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain.
2
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain.
3
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Biostatiscs Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.
4
Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Health Plan Directorate, Ministry of Health, Generalitat de Catalunya, Barcelona, Spain Department of Public Health, Universitat de Barcelona, Barcelona, Spain.
5
Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona-IDIBAPS, Barcelona, Spain.
6
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain Catalan Network of Smoke-free Hospitals, L'Hospitalet de Llobregat, Barcelona, Spain Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain.

Abstract

BACKGROUND:

Mental health units have usually been exempted from complete smoke-free policies. The aim of this study was to compare the self-reported level of exposure to secondhand smoke (SHS) of patients and staff in psychiatric units to objective measures, and examine preference for different types of smoking bans.

METHODS:

Cross-sectional survey about ban preferences and self-reported exposure to SHS by means of a self-administered questionnaire administered to patients and staff from 65 inpatient psychiatric units in Catalonia (95.5% of all units). We measured air concentrations of particulate matter ≤ 2.5 μm (PM2.5 in µg/m(3)) as a marker of SHS in these units.

RESULTS:

600 patients and 575 professionals completed the questionnaire. 78.7% of them were objectively exposed to SHS (PM2.5>10 μm/m(3)) but 56.9% of patients and 33.6% of staff believed they were not exposed at all and 41.6% of patients and 28.4% of staff believed the environment was not at all unhealthy. Nurses had a higher smoking prevalence than psychiatrists (35.8% vs 17.2%; p<0.001), and nurses had a higher perception of being moderately highly exposed to SHS (40.3% vs 26.2%; p<0.001). PM2.5 levels were significantly different depending on the type of smoking ban implemented but unrelated to the perception of SHS levels by both patients and staff. Only 29.3% of staff and 14.1% of patients strongly supported total smoking bans.

CONCLUSIONS:

Patients and staff have substantial misperceptions about the extent of their exposure to SHS and low awareness about the harmful environment in which they stay/work. This might have an influence on the preference for less restrictive smoke-free bans. It is particularly noteworthy that less that one-third of mental health staff supported smoke-free units, suggesting an urgent need for further education about the harmful health effects of SHS.

KEYWORDS:

Health Services; Priority/special populations; Public policy; Secondhand smoke

[Indexed for MEDLINE]

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