Smoking and mental health - NCSCT

6
Population strategies to prevent smoking
in mental disorders
6.1 Introduction
The smoking cessation interventions outlined in Chapter 5 offer effective support
for smokers who want to quit, but their success at an individual level, and indeed
their uptake, depends on individual motivation. As in all smokers, motivation to
quit varies substantially between and within smokers with mental disorders, and
is influenced by a range of factors operating at the population as well as the
individual level including, for example, health promotion campaigns in the
media, the price of tobacco, local and national smoke-free policies, the
prevalence of smoking among peers and friendship groups, and many others.
Many of these factors also influence uptake of smoking. Measures that reduce
smoking in general, and smoke-free policies in particular, also reduce passive
exposure to smoke and to the role-modelling effects of smoking behaviour on
others.
This chapter reviews the population-level tobacco control strategies that
contribute to smoking prevention, first across the general UK population, and
then, where possible, specifically in mental health populations. The chapter also
explores some of the institutional cultural barriers to effective smoking
prevention in these contexts.
6.2 General population strategies
6.2.1 Smoke-free legislation
Under legislation that came into force in Scotland in March 2006, in Wales and
Northern Ireland in April 2007, and in England in July 2007, smoking is now
prohibited in almost all enclosed and substantially enclosed work and public places
in the UK. The primary rationale for this policy, as outlined in the consultation
process for the English legislation, 1 was protection of employees and the general
public from involuntary exposure to tobacco smoke, although it was also
anticipated that comprehensive restrictions on smoking in public and work places
would stimulate quit attempts and hence reduce overall smoking prevalence.
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