Treating nicotine dependence in mental health hospitals

Although guidelines for the treatment of nicotine dependence have been implemented in general hospital settings, treatment does not occur systematically in mental health hospitals. A number of barriers to treatment exist, including ambivalent staff attitudes, the prevalence of staff who smoke, a lack of education and training in nicotine dependence treatment, a lack of nicotine replacement therapy use and knowledge of referral options post discharge and a lack of total smoking bans. Evidence from general hospital settings provides guidance on how to overcome these barriers. A first step is the implementation of total smoking bans. Further, evidence-based clinical practice guidelines and models of care need to be developed, melding the complexities of mental health and nicotine dependence treatment. Clinical systems in hospitals that support the provision of nicotine dependence treatment need to be enhanced. Finally, much more research on interventions is required to provide further evidence of what works.