Can psychiatric and chemical dependency treatment units be smoke free?

The feasibility and appropriateness of establishing smoke-free psychiatric and chemical dependency treatment units are topics of recent interest. This paper reviews the literature on the implementation of smoke-free policies in psychiatric and chemical dependency treatment units. Several issues are addressed including (a) the concerns raised by treatment staff regarding the implementation of a smoke-free policy, (b) the effects of involuntary smoking cessation or reduction on the treatment and/or recovery of patients, (c) the utilization of smoking cessation interventions by patients and staff, and (d) the effects of a smoke-free environment on the smoking behavior of patients and staff. It is concluded that a smoke-free environment is a reasonable and achievable goal in these settings. However, the implementation of a smoke-free policy in chemical dependency treatment units has met with several more problems than those observed in psychiatric settings. Recommendations for further clinical research and program implementation are offered.