It’s generally agreed that smoking is not a healthy habit, but in the case of mental patients, it’s a matter of choosing the lesser evil, and smoking wins


The addiction and social costs of smoking have always had an impact on our society. Since 2007, smoking has been banned in all enclosed work places within the UK as a consequence of the Mental Health Act 2006. However, recently, debates as to whether smoking should be banned from the grounds of Psychiatric hospitals lurk.

‘Smoking is all we did in our free time’. The words of a patient who checked herself into a mental health unit at the age of 18.  She experienced major depressive episodes and wanted to seek help. She didn’t smoke much before going into her sessions, but suggests it was the only way to socialise with the other patients. ‘The patients would get together after therapy sessions to discuss their lives. If you didn’t join the smokers on the bench outside you ended up feeling pretty isolated’. In this case the three-inch tobacco-filled drug is seen as more than just a bad habit, but the catalyst for discussion.

The patient believed (within the community) that when people were at the lowest point in their life, smoking was at the centre of it to help them. According to one report, 42 per cent of all cigarettes smoked in England are done so by people with mental health problems. Hence, giving more reason for the ban not to occur as these groups are more likely to smoke once leaving the hospital. Moreover, it isn’t just the patients in mental health hospitals that smoke, many staff also indulge in the habit. This allows the staff to take time out of their busy day to socialise with patients and other colleagues.

Offering cigarettes to patients is also used to help ease their pain or during interrogations. One doctor admitted: ‘When I was doing my clinical exams, interviewing patients with mental health problems, I was even advised to take a packet of Benson & Hedges in with me to offer to patients’, says Dr Jonathan Campion. By offering them a cigarette, the patient is at ease and is able to cooperate much better. The unit at which the patient is in must act as their home for greater support. One would not stop someone from smoking in the comfort of their own home, so arguably, patients should be allowed to smoke in the unit.

With smoking being banned in various prisons next year in England and Wales, some mental health patients feel as if they are being made to live like prisoners. Feelings of isolation and dire cravings not being fulfilled can also lead to higher suicide rates for mental health patients. Many also believe if they were stopped from smoking on a unit, they would simply find somewhere else to smoke, even if it meant leaving the premises of the hospital. If someone was in a suicidal or manic episode, the arrangement of such a law could be dangerous. Many hospitals are close to busy main roads, so having anxious and depressed mental patients constantly wandering around looking to smoke may not be the safest of ideas.

People with mental health problems have a reduced life expectancy of 10-20 years. Dr Jonathan Campion believes that one of the reasons for this is that only a minority receive the right support and guidance to stop smoking.  He believes that ‘primary care, secondary care and NHS “Stop Smoking Services” must address this issue in a more coordinated way, alongside public health and commissioners’. Banning the act of smoking on hospitals’ grounds would not help the situation, but in fact create more problems and greater aggravation to deal with.

Making the lives of mental health patients easier should be the priority, yet restricting areas in which smoking is permitted is simply going against this primary goal. Yes, ‘Smoking kills’ but for many, it helps keep them alive too, which is why it should remain permissible near hospitals.


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