New King’s College London research reveals a 39 per cent drop in physical assaults – both between patients and towards staff – following the introduction of a smoke-free policy at the South London and Maudsley NHS Foundation Trust (SLaM).

Published in The Lancet Psychiatry, the study has important implications for the introduction of smoke-free policies, not only in psychiatric hospitals but also in other institutions such as prisons.

Smoking within psychiatric hospitals has long been a cultural norm, and is thought to be a major reason why people with mental health problems die 15-20 years earlier than the general population.

In 2013, the National Institute of Health and Care Excellence (NICE) recommended the introduction of smoke-free policies in acute, maternity and mental health services, with on-site help for patients – whether they want to stop smoking or not – to manage their withdrawal symptoms.

As part of SLaM’s policy, smoking is prohibited in the buildings and grounds of its four south London hospitals, smokers are offered stop smoking treatment such as nicotine replacement therapy (NRT) and patients are allowed to use e-cigarettes.

Dr Debbie Robson, Senior Post-Doctoral Researcher in Tobacco Addiction at King’s College London, said: ‘Hopefully our findings will reassure staff that introducing a smoke-free policy does not increase physical violence as is often feared. Historically, cigarettes have been used as a tool to manage patient behaviour and patients often coerce their peers into handing over cigarettes. To support the introduction of the smoke-free policy SLaM invested in new treatment pathways for smokers and a staff training programme, which may have contributed to changing the culture of how staff and patients interact.’

This study was undertaken at the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London, where a team of researchers are investigating ways to help people with severe mental illness to improve their physical health.