Date of Award


Degree Name

Master of Nursing (Research)

Schools and Centres

Nursing and Midwifery

First Supervisor

Dr Richard Bostwick

Second Supervisor

Dr Paola Chivers


Smoking rates among people with a mental illness have not declined and remain a significant and preventable risk factor contributing to increased morbidity and reduced life expectancy. This study aimed to measure commitment, thus underlying attitude of mental health professionals towards provision of tobacco dependence treatment and enablers and barriers to implementing routine tobacco dependence treatment and smoke-free policy in an acute inpatient mental health setting.

A convenience sample of health professionals from an acute inpatient mental health unit were surveyed. This exploratory mixed method study included the Tobacco Treatment Commitment Scale (TTCS), smoking status, the Fagerstrom Test for Nicotine Dependence (FTND) and open-ended questions. Group differences were tested using t tests, ANOVA, chi square or the non-parametric alternative and relationships explored using the General Lineal Model (GLM). Open-ended questions of barriers and enablers to routine treatment of tobacco dependence and operating within smoke-free policy complete ban were thematically coded.

Mental health professionals were ambivalent (TTCS) with males scoring higher (t=3.03, p=.003) than females, and current smokers scoring higher (t=2.70, p=.008) than nonsmokers (M=2.66, SD=0.62). Major barriers were related to mental health acuity and choice of patients to quit smoking, and staff belief that the smoke-free policy should have a partial ban (exemption). Education and training resources was the main enabler theme with additional themes of smoke-free policy (complete ban) and tobacco specialist nurses.

The implementation of smoke-free policy (partial ban) was seen by majority respondents as an enabler for patient care, but in practice is a barrier to smoke free-policy (complete ban) implementation. Mental Health professionals need empirical evidence on tobacco dependence treatment benefits and smoke-free facilities to empower them to take a leading role in shifting long-standing cultural norms around smoking.

Included in

Nursing Commons