So I was first admitted to a psychiatric ward way back in 1990. I had several stays since and my last stay was in February 2021 and to my amazement not much has changed but I’ll try and give an honest account on from my own personal experience.

Firstly I have to start by saying if you’ve never been on a ward or visited someone you probably only have films and documentaries to go on.

Back in the 90’s things were very different and had a small designated smoking room. When you understand the high percentage of smokers within that particular setting, it wasn’t pleasant surroundings. But that’s all history so I’d like to focus on my most recent stay.

The wards are divided into four, an upstairs ward for which I’ll refer to as Northgate and a ground floor ward which I will refer to as Southgate. Then these wards are divided by gender.

I would estimate that 80 – 85% of people on these wards smoke. I also noted which is backed up by studies that people tend to smoke more.

Ironically I was admitted during the covid pandemic and had to spend the first 3 days in isolation. As smoking is obviously not permitted for safety reasons in your room, I was given an e-cigarette.  It looked exactly like a cigarette and even lit up on the tip whilst inhaling but produced no smoke. For someone in crisis and a regular smoker at the time, this wasn’t ideal but enough to get me through.

So after 3 days of isolation I couldn’t wait to get out smoking a real cigarette!

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Statistics suggest people who suffer mental health are seven times more likely to smoke and also smoke heavier as I can bear witness.

These are not fun places for people to be in, they only serve the purpose of keeping yourself or others safe. I observed and also partook in the smoking culture.

They do have an activity room with games, books etc but in my experience these are hardly opened because of the usual lack of staff and supervision. In fact half of the staff are kind, caring and nice, the other half are usually agency staff who are just there for the money and show little if any compassion.

So back to smoking

So if you can imagine the 2 wards I spoke about earlier, Southgate and Northgate. These wards were not allowed to mix so this poses a problem when the only place to smoke is in the courtyard. Due to lack of activities and staff, life pretty much evolved around smoking.

So their solution was to open the courtyard to the different wards alternating every hour.

So many people’s lives revolved around this cycle. It was not unusual to see people smoke 5-10 cigarettes during the hour they were allowed in the courtyard knowing they would have to wait an hour before they could get to smoke again. And so it went on. When your time was up, many people spent their time rolling cigarettes in anticipation of the next smoke break, I am also guilty myself and people would sit around watching the clock and some even queuing at the door waiting for 45 minutes.


These are amongst the most vulnerable people in society and being allowed out to smoke is also seen as some kind of reward system, compliance of good behaviour or taking your medication.

It’s a well-documented fact the adverse effects of smoking and all the related life-shortening illnesses associated with smoking.

What is less documented is antipsychotic medication can cut your lifespan between 15 and 18 years.

Combined this is a recipe for disaster!

However, to just quit smoking while taking psychotropic medication comes with its own set of health issues.  Quitting nicotine can affect the chemical balances in your brain and can affect the way your medication works and requires close monitoring. Personally I think mental health practitioners, psychologists and psychiatrists should put more emphasis into encouraging people to stop smoking.

I also understand that the courtyard where people congregate to smoke is also a time for people to socialise.

So how do we address the issue? If you asked me last year I wouldn’t have had a clue but knowing what I know now disposable vaping would offer a great alternative. It mimics smoking and delivers an amount of nicotine that wouldn’t affect the brain chemistry. Of course there are other nicotine replacement therapies available but nothing mimics smoking and the social aspect of it and if you compare it to the cost of patches etc, it is far more cost efficient and as many studies have shown, the hand to mouth action of smoking is one of the reason it’s hard to break the habit.

These people are often reliant on welfare and it would also offer a cost-effective solution to put more money in their pocket without the compromise.


Perhaps professionals should be encouraging this as an alternative? A lot of these vulnerable people are already sadly destined for a shorter life; surely we should be doing more to help them?