Effect of implementation of a smoke-free policy on physical violence in a psychiatric inpatient setting: an interrupted time series analysis

Robson, Debbie, Spaducci, Gilda, McNeill, Ann, Stewart, Duncan, Craig, Tom J. K., Yates, Mary and Szatkowski, Lisa (2017) Effect of implementation of a smoke-free policy on physical violence in a psychiatric inpatient setting: an interrupted time series analysis. Lancet Psychiatry, 4 (7). pp. 540-546. ISSN 2215-0366

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Abstract / Description

Background:
Smoke-free policies are important to protect health and reduce health inequalities. A major barrier to policy implementation in psychiatric hospitals is staff concern that physical violence will increase. We aimed to assess the effect of implementing a comprehensive smoke-free policy on rates of physical assaults in a large UK mental health organisation.

Methods:
We conducted an interrupted time series analysis of incident reports of physical assault 30 months before and 12 months after the implementation of the policy using a quasi-Poisson generalised additive mixed model.

Findings:
There were 4,550 physical assaults over the study period; 4.9% of which were smoking-related. When adjusted for temporal and seasonal trends and key confounders, there was a 39% reduction in the number of physical assaults per month following the policy introduction compared to beforehand (Incidence Rate Ratio 0.61, 95% CI 0.53-0.70, p<0.001).

Interpretation:
The introduction of a comprehensive smoke-free policy in a large psychiatric organisation appeared to reduce the incidence of physical assaults. Adequately resourced smoke–free policies could be part of broader violence reduction strategies in psychiatric settings.

Item Type:	Article
Uncontrolled Keywords:	smoke-free policies; psychiatric organisations; physical violence of patients
Subjects:	600 Technology > 610 Medicine & health
Department:	School of Social Professions (to June 2021) School of Social Sciences and Professions
Depositing User:	Duncan Stewart
Date Deposited:	13 Aug 2020 08:40
Last Modified:	13 Aug 2020 08:40
URI:	https://repository.londonmet.ac.uk/id/eprint/5974

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