[The smoking situation of patients and staff in a psychiatry hospital. The smoking issue in psychiatry can be considered a neglected problem].

Objective: The present study was conducted to obtain information about smoking status of psychiatric patients and to determine whether there might be a demand for smoking cessation support for this group of people. In addition, the smoking status of psychiatric medical staff members, their awareness regarding smoking and related issues, and their attitude to promotion efforts to ameliorate smoking in their working place were examined.

Methods: Outpatients and inpatients with schizophrenia, mood disorders, and alcoholism in Koutokukai Sato Hospital during December 2001 and May 2002, and staff of the hospital were the subjects in this study. We surveyed smoking status in both 296 patients and 222 staff members.

Results: Smoking rates were 77.4% in males and 39.3% in females among patients with schizophrenia, 87.5% in males and 100% in females among patients with bipolar mood disorders, 69.6% in males and 5.4% in females among patients with depression, and 86.7% in males and 100% in females among patients with alcoholism. Among those smokers, 78.1% were nicotine dependent. However, 75.7% of these smokers were interested in smoking cessation, and 49.0% hoped for prohibition of smoking. The findings thus indicated that the demand for smoking cessation support is high in psychiatric patients. Among the staff, the smoking rate was also high, at 45.5% (males: 76.6% and females: 29.0%). As for the age at beginning of smoking, the peaks were at 18 years old and 20 years old. Smokers who smoked less than 20 cigarettes per day accounted for 80% of the total. Of the smokers, 91.1% recognized that their smoking bothered the people around them. If the working place was smoke free, however, 66.3% answered it would be difficult to adapt, and only 24% wanted to stop smoking recently. On the other hand, 29.8% of the non-smokers were bothered with smoking at the working place, and 76.0% hated smoke of cigarettes. When one wanted a smoker not to smoke, 22.7% of the non-smokers could say so. Of the staff members, 80.0% agreed with anti-smoking measures. However, it appeared that their consciousness of smoking issues was low as medical workers.

Conclusions: The smoking rate of psychiatric patients and the prevalence of nicotine dependence are high. However, half of the subjects in the present study expressed a desire to quit smoking, pointing to a high demand of smoking cessation support. Psychiatric staff at the institution studied had a high smoking rate, and their recognition of smoking issues was low.