{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T17:47:41Z","timestamp":1781027261297,"version":"3.54.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T00:00:00Z","timestamp":1607126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C37440\/A27015"],"award-info":[{"award-number":["C37440\/A27015"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>In line with national guidance, mental health Trusts in England are implementing complete smoke-free policies. We investigated inpatients\u2019 changes in smoking behavior, tobacco dependence, vaping, and motivation to stop smoking between pre-admission and post-discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We surveyed acute adult mental health inpatients from 14 wards in three mental health Trusts in England in 2019. Structured face-to-face and telephone interviews with patients who smoked on or during admission were conducted during the admission period and at one week and one month after discharge. Data on smoking status; daily cigarette consumption; Heaviness of Smoking Index (HSI); Strength of Urges to Smoke (SUTS); Motivation to Stop Smoking (MTSS) and vaping were collected and analyzed using regression and probit models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Inpatient smoking prevalence was 51.9%, and a total of 152 of all 555 eligible smokers (27%) were recruited. Attrition was high: 49.3% at the first and 50.7% at the second follow-up interview. Changes in self-reported smoking status, motivation to quit, and vaping did not change significantly over the study period. Cigarette consumption (p &amp;lt; 0.001) and Heaviness of Smoking Index (p &amp;lt; 0.001) modestly reduced. The frequency and strength of urges to smoke (p = 0.011 and 0.012, respectively) decreased modestly after discharge but were scored as high by 57% and 60% of participants during admission respectively. Just over half (56%) reported being offered smoking cessation support on admission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study identified very modest changes in smoking-related outcomes during and after admission and indicates major challenges to smoke-free policy implementation, including limited support for patients who smoke.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>Despite mental health Trusts in England had developed and implemented smoke-free policies to meet national guidelines, adherence to these policies and provision of effective smoking cessation and temporary abstinence support for inpatients admitted to acute adult mental health wards appear to be limited. Patients who smoke on admission are likely to continue to do so during admission and after discharge, and only a very modest change in smoking behaviors appears to take place. Important opportunities to promote smoking cessation in this population are missed. Barriers to effective support need to be identified and addressed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntaa258","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T12:30:42Z","timestamp":1606998642000},"page":"1010-1018","source":"Crossref","is-referenced-by-count":2,"title":["Investigating Changes in Patients\u2019 Smoking Behavior, Tobacco Dependence, and Motivation to Stop Smoking Following a \u201cSmoke-Free\u201d Mental Health Inpatient Stay: Results From a Longitudinal Survey in England"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5934-819X","authenticated-orcid":false,"given":"Tom S","family":"Ainscough","sequence":"first","affiliation":[{"name":"School of Healthcare, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Hewitt","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Horspool","sequence":"additional","affiliation":[{"name":"Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pete","family":"Stewart","sequence":"additional","affiliation":[{"name":"Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-3971","authenticated-orcid":false,"given":"Suzy","family":"Ker","sequence":"additional","affiliation":[{"name":"Tees, Esk and Wear Valleys Foundation NHS Trust, Stockton-on-Tees, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Colley","sequence":"additional","affiliation":[{"name":"Tees, Esk and Wear Valleys Foundation NHS Trust, Stockton-on-Tees, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Paul","sequence":"additional","affiliation":[{"name":"Leeds and York Partnership NHS Foundation Trust, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Hough","sequence":"additional","affiliation":[{"name":"Vale Royal Relative Support Group, Chester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Hough","sequence":"additional","affiliation":[{"name":"Vale Royal Relative Support Group, Chester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Britton","sequence":"additional","affiliation":[{"name":"UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ratschen","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,5]]},"reference":[{"key":"2021052607111698100_CIT0001","author":"Statistics NOf.","year":"2017"},{"key":"2021052607111698100_CIT0002","volume-title":"Smoking and Mental Health","author":"Royal College of Physicians, Royal College of Psychiatrists","year":"2013"},{"issue":"3","key":"2021052607111698100_CIT0003","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1093\/ntr\/ntu173","article-title":"Diverging trends in smoking behaviors according to mental health status","volume":"17","author":"Szatkowski","year":"2015","journal-title":"Nicotine Tob Res"},{"issue":"1\u20132","key":"2021052607111698100_CIT0004","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1080\/0954026021000046047","article-title":"The prevalence of psychiatric morbidity among adults living in institutions (Reprinted from Office for National Statistics, 1996)","volume":"15","author":"Meltzer","year":"2003","journal-title":"Int Rev Psychiatr"},{"issue":"2","key":"2021052607111698100_CIT0005","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1192\/bjp.bp.109.067512","article-title":"Twenty-five year mortality of a community cohort with schizophrenia","volume":"196","author":"Brown","year":"2010","journal-title":"Br J Psychiatry"},{"key":"2021052607111698100_CIT0006","volume-title":"The Stolen Years. 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