Background: There is a close relationship between smoking and psychiatric disorder: a high proportion of people with mental illness smoke, and conversely many adult smokers have a mental illness. Smoke-free policies in psychiatric units have been one strategy suggested for this group.

Objectives: This session aims to review the evidence for smoke-free facilities in assisting in smoking cessation in smokers with mental illness.

Methods: A review of the literature on the proportion of smokers with mental illness who receive inpatient treatment, their smoking rates and average durations of stay, as well as the efficacy of smoking cessation treatments in the acutely ill and whether cessation is maintained following discharge.

Findings: Smoking rates are high among people hospitalised for psychiatric disorders. However, most smokers with mental illness are not in contact with psychiatric services. Of those who are hospitalised, the majority of admissions are of short duration with 57% of admissions lasting 2 days or less. Evidence for smoking cessation therapies is largely restricted to people in psychiatric remission, not those who are acutely ill. Furthermore, long-term effectiveness is unclear: one study reported the median time to relapse following discharge from a smoke-free ward was 5 min.

Conclusions: Most smokers with mental illness are not treated in inpatient facilities, and where inpatient admissions occur, they are generally of short duration. Other strategies are required to support smoking cessation for most smokers with mental illness who are not admitted or otherwise in contact with mental health services.