Journal of Psychiatric and Mental Health Nursing, 2004, 11, 445–451 © 2004 Blackwell Publishing Ltd 445 DICKENS G. L., STUBBS J. H. & HAW C. M. (2004) Journal of Psychiatric and Mental Health Nursing 11, 445–451 Smoking and mental health nurses: a survey of clinical staff in a psychiatric hospital There is a lack of evidence on the prevalence of smoking among mental health nurses, and the beliefs and attitudes they hold about smoking at work. This paper describes results from a cross-sectional survey of clinical staff working in a UK specialist charitable-status psychi- atric hospital and focuses on the responses of registered mental health nurses. Question- naires specifically developed for this study were sent to all 1371 clinical employees. Completed questionnaires were returned by 167 of 429 (38.9%) registered nurses (RNs), 300 of 842 (35.6%) nursing assistants (NAs), and 123 of 200 (61.5%) other health pro- fessionals (OHPs). Twenty-nine (17.4%) RNs, 93 (31%) NAs and eight (6.5%) OHPs reported themselves as current smokers. Differences in response to attitudinal questions between groups could not be attributed to age. RN smokers were significantly more likely than RN non-smokers to state that staff should be allowed to smoke with patients, and to report therapeutic value for patients in this activity. RN smokers were less likely than RN non-smokers to report that patients should be encouraged to stop smoking. RNs were sig- nificantly more likely than OHPs to report therapeutic value for patients in smoking with staff, even after controlling for the possible confounding effect of smoking status. Implica- tions of the survey are discussed in the context of the international literature, including the disproportionately high smoking prevalence among patients living in psychiatric institutions and current guidelines to move towards no ‘smoking allowed’ areas for staff working in them. Keywords: attitudes, mental health nurses, psychiatric nurses, smoking Accepted for publication: 22 January 2004 et al. . Smoking and mental health nurses: a survey of clinical staff in a psychiatric hospital G. L. DICKENS 1 RMN BS c (h ons ) , J. H. STUBBS 2 MS c MRP harm s & C. M. HAW 3 MA MB BC hir MRCP MRCP sych 1 Research Nurse/Research Co-ordinator, 2 Head Pharmacist and 3 Consultant Psychiatrist, St Andrew’s Hospital, Northampton, UK Correspondence: G. Dickens Research Department Lady Braye Consulting Suite St Andrew’s Hospital Billing Road Northampton NN1 5DG UK E-mail: gdickens@standrew.co.uk Introduction Smoking and disease-related exposure to environmental tobacco smoke has, of late, become more prominent on the public health agenda. For example, the government has moved to ban tobacco sponsorship of sporting events (Department of Health 2002) and European directives have led to an extension of the size and content of warnings on tobacco products (Batty 2002). In the medical community, the British Medical Association (2002) has called for a ban on smoking in public places, including workplaces. In addi- tion, the medical journal Lancet has called for an outright ban on smoking and tobacco sales (Lancet 2003). The UK government has, for the time being, ruled out legislation to ban smoking in public (Hall 2003). Around 13 million (28%) adults in the UK smoke and there are 120 000 deaths each year from smoking-related causes (Department of Health 1998). Rowe & McLeod