Rauchverhalten bei Patienten und Beschäftigten einer psychiatrischen Klinik: zwei unabhängige Stichtagserhebungen im Abstand von 8 Jahren

Zusammenfassung

Anliegen Ziel der Studie war, die Prävalenz und das Rauchverhalten vor und nach der Einführung von Maßnahmen zum Nichtraucherschutz und Angeboten zur Tabakentwöhnung zu untersuchen.

Methode In 2 unabhängigen Stichtagsuntersuchungen (2007/2015) wurden Patienten und Beschäftigte einer psychiatrischen Klinik befragt.

Ergebnisse Der Raucheranteil war zu beiden Zeitpunkten bei den Patienten mit 59 % und 57 % sehr hoch. Bei den Beschäftigten lag er bei 35 % und 33 %. Patienten waren schwerer nikotinabhängig als Beschäftigte. Von allen Rauchern wollten bis zu 57 % das Rauchen aufgeben.

Schlussfolgerungen Die hohe Prävalenz des Rauchens und die starke Nikotinabhängigkeit wurden in beiden Stichproben beobachtet. Zur Senkung dieser sind konsequentere Maßnahmen in psychiatrischen Kliniken sowie gesamtgesellschaftlich notwendig.

Abstract

Objective In order to evaluate the prevalence and smoking behaviour in a psychiatric hospital two independent surveys in 2007 (t1) and 2015 (t2) were carried out before and after implementing strategies to protect non-smokers and to offer assistance to stop smoking.

Methods In two cross-sectional surveys all in-patients and staff of the Centre for Psychiatry Ravensburg-Bodensee were interviewed by questionnaire.

Results The prevalence of smoking among patients was very high at both time points with 59 % (t1) and 57 % (t2), respectively. Among staff, the prevalence of smoking was 35 % (t1) and 33 % (t2). In both surveys, patients were more severely nicotine-dependent than staff. 57 % of all smokers wanted to stop smoking.

Conclusions High prevalence and strong nicotine dependence of patients and staff were observed in both surveys in 2007 and 2015, respectively. More rigorous interventions in psychiatric hospitals and the society as a whole seem to be required to decrease the prevalence of smoking among psychiatric patients and staff.

Schlüsselwörter

Rauchen - Tabakabhängigkeit - Psychiatrie

Keywords

smoking - nicotine dependence - psychiatry

• Literatur

• 1 Landtag Baden-Württemberg. Landesnichtraucherschutzgesetz. LNRSCHG vom 2007
• 2 Statistisches Bundesamt. Mikrozensus-Fragen zur Gesundheit. 2013
• 3 Royal College of Physicians, Royal College of Psychiatrists. Smoking and mental health. London: RCP; 2013
• 4 Lawn S, Campion J. Achieving smoke-free mental health services: lessons from the past decade of implementation research. Int J Environ Res Public Health 2013; 10: 4224-4244
• 5 Lasser K, Boyd JW, Woolhandler S. et al. Smoking and mental illness: A population-based prevalence study. JAMA 2000; 284: 2606-2610
• 6 Schulz M, Topper M, Behrens J. Smoking habits of employees and patients in the psychiatric department of a general hospital. Gesundheitswesen 2004; 66: 107-113
• 7 Virtanen M, Vahtera J, Batty GD. et al. Health risk behaviors and morbidity among hospital staff – comparison across hospital ward medical specialties in a study of 21 Finnish hospitals. Scand J Work Environ Health 2012; 38: 228-237
• 8 An F-R, Xiang Y-T, Yu L. et al. Prevalence of nursesʼ smoking habits in psychiatric and general hospitals in China. Arch Psychiatr Nurs 2014; 28: 119-122
• 9 Batra A. Tobacco use and smoking cessation in the psychiatric patient. Fortschr Neurol Psychiatr 2000; 68: 80-92
• 10 Solty H, Crockford D, White WD. et al. Cigarette smoking, nicotine dependence, and motivation for smoking cessation in psychiatric inpatients. Can J Psychiatry 2009; 54: 36-45
• 11 de Leon J, Becona E, Gurpegui M. et al. The association between high nicotine dependence and severe mental illness may be consistent across countries. J Clin Psychiatry 2002; 63: 812-816
• 12 Grempler J, Droste-Arndt H, Flammer E. et al. Wish to change smoking behaviour among staff and patients of a psychiatric hospital. Psychiat Prax 2012; 39: 164-168
• 13 Lederbogen F, Schwarz P, Hafner S. et al. Cardiac and metabolic risk factors in severe mental disorders. Task of a prevention manager. Nervenarzt 2015; 86: 866-871
• 14 Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis 2006; 3: A42
• 15 Schroeder SA, Morris CD. Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. Annu Rev Public Health 2010; 31: 297-314 1p following 314
• 16 Rüther T, Bobes J, De Hert M. et al. EPA Guidance on tobacco dependence and strategies for smoking cessation in people with mental illness. Eur Psychiatry 2014; 29: 65-82
• 17 Heatherton TF, Kozlowski LT, Frecker RC. et al. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict 1991; 86: 1119-1127
• 18 Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983; 51: 390-395
• 19 StatSoft Inc. STATISTICA für Windows: Software-System für Datenanalyse. Hamburg: Statsoft.de; 2007
• 20 Hochstetter B. Zur Entwicklung des Rauchverhaltens in den letzten 20 Jahren. Zeigen Rauchverbote Wirkung?. Statistisches Monatsheft Baden-Württemberg 2016; 15-20
• 21 Kourakos M, Kalokairinou A, Zyga S. et al. Views and Attitudes of Patients in Mental Facilities Regarding Smoking. Glob J Health Sci 2016; 8: 54508
• 22 Ribeiro de Barros FC, Melo APS, Cournos F. et al. Cigarette smoking among psychiatric patients in Brazil. Cad Saude Publica 2014; 30: 1195-1206
• 23 Michopoulos I, Rizos E, Gournellis R. et al. Smoking reduction in psychiatric inpatients is feasible: results from a 12-month prospective study. Ann Gen Psychiatry 2015; 14: 4
• 24 Barnett PG, Wong W, Jeffers A. et al. Cost-effectiveness of smoking cessation treatment initiated during psychiatric hospitalization: analysis from a randomized, controlled trial. J Clin Psychiatry 2015; 76: e1285-1291
• 25 Stockings EA, Bowman JA, Prochaska JJ. et al. The impact of a smoke-free psychiatric hospitalization on patient smoking outcomes: a systematic review. Aust N Z J Psychiatry 2014; 48: 617-633
• 26 Ortiz G, Schacht L, Lane GM. Smoking cessation care in state-operated or state-supported psychiatric hospitals: from policy to practice. Psychiatr Serv 2013; 64: 666-671
• 27 Filia SL, Gurvich CT, Horvat A. et al. Inpatient views and experiences before and after implementing a totally smoke-free policy in the acute psychiatry hospital setting. Int J Ment Health Nurs 2015; 24: 350-359
• 28 Stockings EA, Bowman JA, Bartlem KM. et al. Implementation of a smoke-free policy in an inpatient psychiatric facility: Patient-reported adherence, support, and receipt of nicotine-dependence treatment. Int J Ment Health Nurs 2015; 24: 342-349