The effect of a restricted smoking policy on motivation to quit smoking in psychiatric patients

As dissatisfaction with unrestricted smoking in institutional settings has grown, a number of psychiatric facilities have banned smoking. A compromise, restricted smoking, was recently introduced on an inpatient psychiatric unit at a University of Michigan Hospital. The subsequent rescission of the restricted smoking policy enabled us to compare the effects of restricted smoking vs. ad lib smoking on motivation to quit smoking.

Current smokers admitted to an inpatient psychiatry unit were asked to participate in this study. As soon as possible after intake, the patient completed a smoking history questionnaire, depression and anxiety scales, and a stage of change measure. The stage of change measure was readministered upon discharge from the unit.

Repeated measures ANOVA revealed an interaction for Condition (Restricted vs. Ad Lib) by Time (Admission vs. Discharge) for the Action scale, which assesses current level of activity in smoking cessation efforts. Restricted smokers decreased while ad lib smokers increased in motivation over time.

Results suggest that the restricted smoking policy does not have beneficial motivational effects. Alternative strategies for controlling smoking on an inpatient psychiatric unit are suggested.