Impact of a total smoking ban in a high secure hospital

Aims and method To assess the impact of a total smoking ban in a high secure psychiatric hospital. Staff and patients were surveyed before and after implementation. Data were collected on untoward incidents, seclusions, nicotine replacement therapy and changes in psychotropic medication. Results Of the 298 patients in the hospital for the evaluation period, 72.8% were smokers before the ban. There were no significant differences in rates of seclusion before and after the ban and only one significant comparison (P = 0.01) showed an increase in untoward incidents for smokers. There were no significant increases in the use of psychotropic medication after the ban. Clinical implications With adequate preparation, it is possible to implement a total smoking ban in a high secure psychiatric setting without serious negative consequences.