Impact and Barriers for the Restriction of Smoking
					During Psychiatric Hospitalization: An Integrative Review

Oliveira, Renata Marques de; Furegato, Antonia Regina Ferreira

doi:10.1590/1982-43272458201414

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Systematic Literature Review • Paidéia (Ribeirão Preto) 24 (58) • May-August 2014 • https://doi.org/10.1590/1982-43272458201414 copy

Impact and Barriers for the Restriction of Smoking During Psychiatric Hospitalization: An Integrative Review¹ 1 Article derivative from the master’s thesis of the first author, guided by the second author and defended in the Graduate Program in Psychiatric Nursing of the Ribeirão Preto College of Nursing in 2012.

Impacto e Barreiras da Restrição ao Tabagismo na Internação Psiquiátrica: Revisão Integrativa

Impacto y Barreras de la Restricción al Tabaquismo en la Internación Psiquiátrica: Revisión Integradora

SCIMAGO INSTITUTIONS RANKINGS

The aim was to identify the barriers for implementing the restriction on smoking in psychiatric hospitalization services, its impact on the hospitalized smokers, and the positioning of the professionals. Integrative review of 19 articles published (1989-2011) in MEDLINE and SCOPUS. Descriptive analysis was carried out. The studies revealed that the main barriers for the implementation of the restriction were: beliefs in the patients’ increased aggressiveness, damage to the professional-patient relationship, and lack of preparation to address the theme. After the implementation, the restrictions showed a positive impact: reduction of cigarettes smoked, increased motivation to quit smoking, and more attempts to stop smoking. The professionals who smoked and those who did not believe that quitting smoking benefits mental health patients were those that least supported the implementation of the restrictions. In conclusion, the restriction on smoking is effective in psychiatric hospitalization, as it provokes an attitude of change in mental health patients.

mental disorders; psychiatric patients; smoking; mental health services; nursing

Code	Title (year)
1	Nicotine replacement prescribing trends in a large psychiatric hospital, before and after implementation of a hospital-wide smoking ban (Scharf, Fabian, Fichter-DeSando, & Douaihy, 2011).
2	Total smoking ban in psychiatric inpatient service: a survey of perceived benefits, barriers and support among staff (Wye et al., 2010).
3	The impact of opening a smoking room on psychiatric inpatient behavior following implementation of a hospital-wide smoking ban (Crockford, Kerfoot, & Currie, 2009).
4	Smoking bans in a psychiatry department: are nonsmoking employees less exposed to environmental tobacco smoke? (Vorspan et al., 2009).
5	Smoking prevalence among qualified nurses in the Republic of Ireland and their role in smoking cessation (O’Donovan, 2009).
6	Variations in smoke after admission to psychiatric inpatients units and impact of a partial smoking ban on smoking and on smoking related perceptions (Keizer et al., 2009).
7	Changes in psychiatric patients’ thoughts about quitting smoking during a smoke-free hospitalization (Shmueli, Fletcher, Hall, Hall, & Prochaska, 2008).
8	Acceptability and impact of a partial smoking ban followed by a total smoking ban in a psychiatric hospital (Etter, Khan, & Etter, 2008).
9	Exploration of inpatient attitudes towards smoking within a large mental health trust (Smith & O’Callaghan, 2008).
10	Acceptability and impact of a partial smoking ban in a psychiatric hospital (Etter & Etter, 2007).
11	A survey of staff attitudes to smoking-related policy and intervention in psychiatric and general health care settings (McNally et al., 2006).
12	The effects of a non-smoking policy on nursing staff smoking behavior and attitudes in a psychiatric hospital (Bloor, Meeson, & Crome, 2006).
13	Exposure to environmental tobacco smoke (ETS) and determinants of support for complete smoking bans in psychiatric settings (Willemsen, Gorts, Van Soelen, Jonkers, & Hilberink, 2004).
14	Survey of staff attitudes to smoking in a large psychiatric hospital (Stubbs, Haw, & Garner, 2004).
15	Obligatory cessation of smoking by psychiatric inpatients (Smith, Pristach, & Cartagena, 1999).
16	Implementing smoking bans in American hospitals: results of a national survey (Longo et al., 1998).
17	Implementation of a smoking ban on a locked psychiatric unit (Ryabik, Lippmann, & Mount, 1994).
18	The feasibility of smoking bans on psychiatric units (Taylor et al., 1993).
19	Effects of a smoking ban on a general hospital psychiatric unit (Thorward & Birnbaum, 1989).

Universidade de São Paulo, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Programa de Pós-Graduação em Psicologia Av.Bandeirantes 3900 - Monte Alegre, 14040-901 Ribeirão Preto - São Paulo - Brasil, Tel.: (55 16) 3315-3829 - Ribeirão Preto - SP - Brazil
E-mail: paideia@usp.br

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[1] Correspondence address: Renata Marques de Oliveira. Rua Mato Grosso, 285, Centro. CEP 17509-090. Marília-SP, Brazil. E-mail: renatamarques@ymail.com