| Summary: | Background:
Smoke-free policies are important to protect health and reduce health inequalities. A major barrier to policy implementation in psychiatric hospitals is staff concern that physical violence will increase. We aimed to assess the effect of implementing a comprehensive smoke-free policy on rates of physical assaults in a large UK mental health organisation.
Methods:
We conducted an interrupted time series analysis of incident reports of physical assault 30 months before and 12 months after the implementation of the policy using a quasi-Poisson generalised additive mixed model.
Findings:
There were 4,550 physical assaults over the study period; 4.9% of which were smoking-related. When adjusted for temporal and seasonal trends and key confounders, there was a 39% reduction in the number of physical assaults per month following the policy introduction compared to beforehand (Incidence Rate Ratio 0.61, 95% CI 0.53-0.70, p<0.001).
Interpretation:
The introduction of a comprehensive smoke-free policy in a large psychiatric organisation appeared to reduce the incidence of physical assaults. Adequately resourced smoke–free policies could be part of broader violence reduction strategies in psychiatric settings.
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