To assess the impact of a partial smoking ban followed by a total smoking ban in a psychiatric hospital in Switzerland. In this hospital in 2003, smoking was allowed everywhere except in bedrooms and dining rooms. In 2004, smoking was prohibited everywhere except in closed smoking rooms. In 2006, smoking rooms were suppressed and smoking was prohibited everywhere inside hospital buildings.

Patients and staff were surveyed in 2003 (n=106), 2004 (n=108), 2005 (n=119) and 2006 (n=134).

Most participants (55%) answered that the total ban was too strict and preferred the partial ban. Self-reported exposure to environmental tobacco smoke (ETS) improved in dining rooms, corridors and offices after the partial smoking ban and further improved after the total ban. Exposure to ETS in bedrooms improved after introduction of the partial ban, but was not further improved by the total ban. Among patients, more smokers reported having made a quit attempt during their hospital stay after (18%) than before the total smoking ban (2%, odds ratio=10.1, p=0.01), and more smokers said that hospital staff gave them nicotine replacement medications after (52%) than before the total ban (13%, odds ratio=7.6, p<0.001).

The partial smoking ban decreased exposure to ETS and the total ban further improved the situation, even though neither the partial nor the total bans were strictly enforced. The total ban increased the proportions of smokers who made a quit attempt and received nicotine medications.