National Association of State Mental Health Program, Directors Research Institute, Inc., 3141 Fairview Park Dr., Suite 650, Falls Church, VA 22042, USA.
Psychiatr Serv. 2013 Jul 1;64(7):666-71. doi: 10.1176/appi.ps.201200290.
The aims of this study were to identify changes in smoking policies and their implementation and to determine the level of smoking cessation care provided at state-operated or state-supported psychiatric inpatient hospitals.
Hospitals were surveyed in 2008 (N=219) and 2011 (N=206) about their smoking policies and practices, and changes in specific policies and practices, such as staff specialty training about smoking cessation care, assessment at intake, provision of smoking cessation treatment and education, and aftercare planning, were examined. Smoking cessation care was categorized as best, good, average, or poor.
The survey was completed in both 2008 and 2011 by 108 hospitals. The number of hospitals prohibiting smoking rose by 73%, from 48% in 2008 to 83% in 2011. The provision of specialty training to staff did not significantly improve. Nearly all hospitals assessed smoking status at admission, and nicotine replacement therapy was provided by more hospitals than any other treatment in both 2008 and 2011. The number of hospitals providing no follow-up of smoking cessation care after discharge dropped significantly, from 64% to 41%, and significantly more provided good versus average smoking cessation care.
Analysis of smoking policies at state-operated or state-supported psychiatric inpatient hospitals found significant movement in adopting nonsmoking policies and some increase in active treatment, notably wellness counseling. Educational resources have not reached full penetration, and continuum of care activities are also lagging behind. Additional resources and staff training may be needed to continue to address smoking cessation both during and after hospitalization.
本研究旨在确定吸烟政策的变化及其实施情况，并确定州立或州立支持的精神病住院医院提供的戒烟护理水平。
2008 年（N=219）和 2011 年（N=206）对医院的吸烟政策和实践进行了调查，并对具体政策和实践的变化进行了检查，例如有关戒烟护理的员工专业培训、入院评估、提供戒烟治疗和教育以及康复计划。戒烟护理被分为最佳、良好、一般和较差。
共有 108 家医院完成了 2008 年和 2011 年的调查。禁止吸烟的医院数量增加了 73%，从 2008 年的 48%增加到 2011 年的 83%。向员工提供专业培训的情况并没有显著改善。几乎所有医院在入院时都评估了吸烟状况，并且在 2008 年和 2011 年，尼古丁替代疗法的提供都超过了其他任何治疗方法。不提供出院后戒烟护理随访的医院数量显著下降，从 64%降至 41%，并且提供良好戒烟护理的医院明显多于一般护理。
对州立或州立支持的精神病住院医院的吸烟政策进行分析发现，采用非吸烟政策的显著变化和积极治疗的增加，特别是健康咨询。教育资源尚未全面普及，护理连续性活动也滞后。可能需要更多的资源和员工培训，以继续在住院期间和出院后解决戒烟问题。
