Lancet study debunks one of the greatest mental health myths

Research just published in the June Lancet Psychiatry 2017 journal has shown physical assaults in a UK psychiatric hospital reduced by 39% when a smokefree policy was introduced and supported with proper clinical treatment of nicotine withdrawal.

According to Dr Sarah White, Director of Quit Victoria, this research demolishes the toxic myth – originally perpetuated by the tobacco industry – that smoking is a helpful tool for people living with mental illness.

“For years the tobacco industry has tried to cement the idea in mental health settings that smoking helps with stress and that making these facilities smokefree will result in extra aggression and violence towards staff and other patients, but if you look at the data it couldn’t be further from the truth.

“In fact, we now know that quitting smoking improves your mental health and in some cases means people can decrease their medication doses. It’s important to note that in this study patients were provided with nicotine replacement therapy products to clinically manage nicotine withdrawal which is a vital element of any smoking cessation program.

“We are really encouraged by this research that proves overall everyone in the facilities was safer with all physical assaults down by 39%, and in particular staff were significantly safer with patient-towards-staff assaults nearly halved (47%),” said Dr White.  

Quit Victoria has been working with several mental health facilities across the state to pilot smoking cessation support programs. NorthWestern Mental Health is a key partner in the project.

A/Prof Ruth Vine, Executive Director NorthWestern Mental Health said “When you look at the evidence, it would be negligent not to be focussing on supporting people living with mental illness to quit. Smokers are two and half times more likely to attempt suicide1 than non-smokers, and smoking contributes to people living with a mental illness dying 10–20 years earlier than the general population2,” she said.

The research found additional cost and resourcing benefits from the hospitals going smokefree.

“By removing the need for smoking supervision, the research found significant cost and staff time savings. In this project, the costs of facilitating patient smoking totalled £131,040 (approx. AUD220,000) across four wards, equating to 6028 hours of staff time over a year,” concluded Dr White.

The full story is available on The Lancet Psychiatry website.


  1. Poorolajal J, Darvishi N (2016) Smoking and Suicide: A Meta-Analysis. PLoS ONE 11(7): e0156348. doi:10.1371/journal.pone.0156348
  2. Brown S, Inskip H, Barraclough B. Causes of the excess mortality of schizophrenia. Br J Psychiatry 2000 Sep;177:212-7
    Brown S, Kim M, Mitchell C, Inskip H. Twenty-five year mortality of a community cohort with schizophrenia. Br J Psychiatry 2010 Feb;196(2):116-21
    Australian Institute of Health and Welfare. Australia's Health 2006. Canberra: AIHW; 2006. Contract No.: Cat. No. AUS 73