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February 6, 2008

Eliminating Tobacco Use in Mental Health Facilities: Patients' Rights, Public Health, and Policy Issues

Author Affiliations

Author Affiliation: University of Medicine & Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey.

JAMA. 2008;299(5):571-573. doi:10.1001/jama.299.5.571

The US public mental health system must address the issue of tobacco use in psychiatric hospitals. Programs that treat behavioral health problems such as depression or schizophrenia are the only remaining sector of health care that fail to systematically help patients quit smoking. At state-funded psychiatric hospitals, medical directors and administrators are attempting to enact policies that restrict tobacco use in these facilities—not only in buildings but on all adjacent outdoor areas or grounds. Some advocates for the mentally ill are opposing these policy changes, using legal means to stall or overturn them. A lawsuit was filed in September 2007 by 6 patients against the largest state hospital in Connecticut, claiming a violation of their civil rights by the restriction of smoking at the facility.1 Other psychiatric hospitals have faced similar cases and opposition from local disability rights groups.2-4 The mere threat of legal or political action has been effective in getting states to rescind or exempt psychiatric or addictions treatment facilities from tobacco-free policies.3,5