Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
South London & Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
Int J Environ Res Public Health. 2020 Dec 1;17(23):8951. doi: 10.3390/ijerph17238951.
Comprehensive smokefree policies in health care settings can have a positive impact on patients' smoking behaviour, but implementation is impeded by concern that surreptitious smoking may increase fire incidents. We investigated the incidence of routinely reported fire and false alarm incidents in a large mental health organisation in England over an 81-month period when different elements of a smokefree policy were implemented. We used negative binomial regression models to test associations between rates of fire and false alarm incidents and three hospital smokefree policy periods with mutual adjustment for occupied bed days: (1) an indoor policy which allowed disposable e-cigarettes; (2) a comprehensive policy which allowed disposable e-cigarettes; and (3) a comprehensive policy with all e-cigarette types allowed. We identified 90 fires and 200 false alarms. Fires decreased (incidence rate ratio (IRR): 0.35, 95% CI: 0.17-0.72, = 0.004) and false alarms increased (IRR: 1.67, 95% CI: 1.02-2.76, = 0.043), each by approximately two-thirds, when all e-cigarette types were allowed, after adjusting for bed occupancy and the comprehensive smokefree policy. Implementation of smokefree policies in mental health care settings that support use of all types of e-cigarettes may reduce fire risks, though measures to minimise effects of e-cigarette vapour on smoke detector systems may be needed to reduce false alarm incidents.
全面的无烟政策在医疗机构可以对患者的吸烟行为产生积极影响，但实施受到担忧的阻碍，即秘密吸烟可能会增加火灾事件。我们调查了在英格兰一个大型心理健康组织中，在实施不同无烟政策要素的 81 个月期间，常规报告的火灾和误报事件的发生率。我们使用负二项回归模型来测试火灾和误报事件发生率与三个医院无烟政策时期之间的关联，这些时期相互调整了占用床位天数：（1）允许使用一次性电子烟的室内政策；（2）允许使用一次性电子烟的综合政策；（3）允许所有电子烟类型的综合政策。我们确定了 90 起火灾和 200 起误报。当允许所有电子烟类型时，火灾减少（发病率比（IRR）：0.35，95%置信区间：0.17-0.72， = 0.004），误报增加（IRR：1.67，95%置信区间：1.02-2.76， = 0.043），在调整床位占用和全面无烟政策后，这两个数字都约减少了三分之二。在心理健康保健环境中实施支持使用所有类型电子烟的无烟政策可能会降低火灾风险，但可能需要采取措施来最大程度地减少电子烟蒸汽对烟雾探测器系统的影响，以减少误报事件。
