BMJ  2006;333:551 (9 September), doi:10.1136/bmj.333.7567.551-b

Letter

Exempting mental health units from smoke-free laws

Nicotine can have beneficial effects

The first 150 words of the full text of this article appear below.

EDITOR—Campion et al argue that psychiatric units should not be exempt from smoking bans, but they do not discuss several issues.¹

Nicotine can have beneficial effects on mood, anxiety, and cognition, and it ameliorates some of the side effects of psychotropic drugs. Acute nicotine withdrawal can exacerbate psychiatric symptoms and cause diagnostic difficulty. Cigarette smoke also induces the metabolism of many different psychotropic drugs.² Therefore, enforcing acute smoking cessation in mentally unwell patients may cause serious problems, including making the patient feel worse, clouding the clinical picture, worsening the side effects of prescribed drugs, and precipitating drug toxicity. When the patient starts smoking again after discharge, the risk of relapse is increased (secondary to re-stimulation of the hepatic microsomal enzyme system and associated reduction in plasma concentrations of prescribed drugs).

To enforce a smoking ban on patients who are free to leave hospital and who stay of their . . . [Full text of this article]

Crosshouse Hospital, Ayrshire KA2 0BE everett.julyan@nhs.net

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Relevant Article

Exempting mental health units from smoke-free laws

Jonathan Campion, Ann McNeill, and Ken Checinski
BMJ 2006 333: 407-408. [Extract] [Full Text] [PDF]