Hashimoto Kazumichi, Makinodan Manabu, Matsuda Yasuhiro, Morimoto Tsubasa, Ueda Shotaro, Kishimoto Toshifumi
Department of Psychiatry, Faculty of Medicine, Nara Medical University, 840 Shijocho Kashihara, Nara, 634-8522 Japan.
Ann Gen Psychiatry. 2015 Oct 29;14:35. doi: 10.1186/s12991-015-0076-9. eCollection 2015.
A number of studies have reported that smoking rates are higher and smoking cessation rates are lower in patients with mental disorders than in the general population. Despite the harmful effects of smoking, implementing total smoking bans in mental health hospitals is difficult. We investigate the status of smoking bans and the barriers to the implementation of total smoking bans in Japanese mental health hospitals.
A questionnaire survey was administered to the directors of 1242 Japanese mental health hospitals in March 2013.
Forty-nine percent (n = 612) of the hospital directors responded. Of these, 24 % implemented total smoking bans and 14 % limited the bans to hospital buildings. In 66 and 68 % of the remaining hospitals, smoking rooms were located in open and closed wards, respectively, and completely separate from nonsmoking areas. Hospitals that had not implemented total smoking bans were concerned that introducing a total ban would exacerbate patients' psychiatric symptoms (46 %) or increase the incidence of surreptitious smoking (65 %). However, of the hospitals that had implemented total smoking bans, only 2 and 30 % identified "aggravation of psychiatric symptoms" and "increased surreptitious smoking" as disadvantages, respectively. The other concerns regarding the implementation of total smoking bans were staff opposition (21 %) and incidence of smoking around hospital grounds (46 %). These concerns were overcome by educating staff about smoking and cleaning the area around the hospital.
There are some barriers to implementing total smoking bans in Japanese mental health hospitals. However, our study indicates that implementation of total smoking bans in mental health hospitals was minimally problematic and that barriers to the implementation of smoking bans could be overcome. As the current number of hospitals that have implemented total smoking bans is low in Japan, more hospitals should introduce total smoking bans.
多项研究报告称，与普通人群相比，精神障碍患者的吸烟率更高，戒烟率更低。尽管吸烟有害，但在精神卫生医院实施全面禁烟却很困难。我们调查了日本精神卫生医院的禁烟现状以及实施全面禁烟的障碍。
2013年3月，对1242家日本精神卫生医院的院长进行了问卷调查。
49%（n = 612）的医院院长做出了回应。其中，24%实施了全面禁烟，14%将禁烟限制在医院建筑内。在其余医院中，66%和68%的医院分别在开放病房和封闭病房设有吸烟室，且与非吸烟区完全分开。未实施全面禁烟的医院担心，实施全面禁烟会加重患者的精神症状（46%）或增加偷偷吸烟的发生率（65%）。然而，在实施了全面禁烟的医院中，分别只有2%和30%的医院认为“精神症状加重”和“偷偷吸烟增加”是不利因素。关于实施全面禁烟的其他担忧包括工作人员的反对（21%）和医院周边地区的吸烟发生率（46%）。通过对工作人员进行吸烟教育和清理医院周边区域，这些担忧得到了克服。
在日本精神卫生医院实施全面禁烟存在一些障碍。然而，我们的研究表明，在精神卫生医院实施全面禁烟的问题最小，而且禁烟实施障碍是可以克服的。由于目前日本实施全面禁烟的医院数量较少，更多医院应引入全面禁烟措施。
