Smoke Free Policy Impact on those with Mental Illness 1

Smoke Free Policy Impact on those with Mental Illness

Megan Sharpe

California State University, Channel Islands

Health Science Research Methods

HLTH 309

December 6, 2019
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Introduction

The purpose of this literature review is to evaluate the conditions of a smoke free policy’s

impact on the population affected by mental illness. An analysis of the sampling methods,

mythological approaches, data collection, measures, and analytical techniques is articulated from

five different studies. A population that suffers from mental illness tend to rely heavily on self-

soothing remedies. It has been noted that this target population is at a higher risk of substance

abuse. When this population experiences difficulties due to their mental illness the action of

smoking is often a part of their coping mechanism (Hehir, 2012, Hehir, 2013, Huddlestone,

2018, Metse, 2016, & Smith, 2019). This is a methodological literature review on the effects of a

smoke free policy on a population with mental illness, based on the collection of data from five

different studies. The independent variable is the smoke free policy. The dependent variable is

the effect that smoke free policy have on the population of those suffering with mental illness.

Sampling Methods

The objective of research is to choose a population, which pertains to the researcher’s

hypothesis. The population that is emphasized in these five studies are those that are affected by

a smoke free policy that suffer from a mental illness. To accurately represent the population of

those with a mental illness the study would need to be conducted on all the individuals in that

population. That would be time consuming and unrealistic. A sample of those with a mental

illness is taken from the population. A variety of methods are used when selecting the sample

which includes; random, systematic, convenience, cluster, and stratified samples. Of the five

studies conducted they all used the stratified sample method to generate their sample (Hehir,

2012, Hehir, 2013, Huddlestone, 2018, Metse, 2016, & Smith, 2019). Each study had specific

inclusive/exclusive criteria as to allow participants to be selected in the sample.

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Methodological Approaches

There is a variety of methodological approaches that were used in these five studies.

Depending on the focus of the study certain methodological approaches are more appropriate

than others. Each of the studies had an influence of a quantitative approach (Hehir, 2012, Hehir,

2013, Huddlestone, 2018, Metse, 2016, & Smith, 2019). A quantitative approach is based off

numerical evidence. For example, the Implementation of a smoke-free policy in a high secure

mental health inpatient facility: staff survey to describe experience and attitudes used a five-

point Likert scale to quantify the data. The response options were categorized into strongly

agree, agree, unsure, disagree, strongly disagree, which were associated a numerical value to be

later analyzed via one of the analytical techniques (Hehir et al., 2013). Smoking and

environmental characteristics of smokers with a mental illness, and associations with quitting

behaviour and motivation; a cross sectional study used the methodological approach of a cross-

sectional study. The use of observation in this cross-sectional study pertains to the depiction in

which the data is collected and evaluated (Metse et al., 2016). The other studies used a mixed

methods evaluation which is a combination of both quantitative and qualitative approaches

(Hehir, 2012, Huddlestone, 2018, & Smith, 2019). The mixed method approach gives a broader

description in terms of data collection. Although there was a different methodological approach

conducted in the studies, the use of quantitative data is transparent in a majority of the studies.

Data Collection

Overall, a study is conducted to provide evidence that either supports or disproves the

hypothesis. Data collection is the means in which provides this evidence. There are a few
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different methods to be used in data collection. It is interesting that two of the studies used focus

groups as a form to collect data (Hehir, 2013, & Smith, 2019). The semi-structured focus groups

provided an environment that promoted a discussion with participants on the subject of smoke

free policies (Hehir et al., 2013). The other three studies incorporated a mixture of different data

collection methods. The use of a structured face to face interview, surveys, the collection of

participant demographics, and personal medical records were incorporated to gather as much

data (Hehir, 2012, Huddlestone, 2018, & Metse, 2016). Since there are different data collection

methods, the importance is selecting the method that will best address the concerns of the

research.

Analytical Techniques

Analytical techniques are used in studies to allow the researchers to make an inference

based on the data collected. The use of a statistical test is reliant in four of the five studies. The

data collected is imputed to a computer program where the results are displayed (Hehir, 2012,

Hehir, 2013, Huddlestone, 2018, & Metse, 2016). Depending on the study different programs

were used (Hehir, 2012, Hehir, 2013, Huddlestone, 2018, & Metse, 2016). This is attributed to

the preference of the researcher or the capability of the program. After the data is imputed the

results are displayed. The depiction of the charts represents the data collected. The use of the chi

square was a commonality in all of the studies that used statistic to indicate evidence in support

of their findings.

Measures

The accuracy of a study pertains to the measures. Research measures account for the

reliability and validity of the study. To ensure the study is an accurate representation measures

should be considered and abided in the study. Only two studies that provided measures to ensure
Smoke Free Policy Impact on those with Mental Illness 5

reliability and validity (Hehir, 2013, & Smith, 2019). To ensure the validity and reliability of the

study certain procedures were incorporated. For instance, the study Implementation of a smoke-

free policy in a high secure mental health inpatient facility: staff survey to describe experience

and attitudes took measures to ensure the accuracy of the study. The implementation of

reviewing the survey questionnaire was done to ensure that the wording was understandable and

that the content was clear (Hehir et al., 2013). Unfortunately, the other studies did not address the

measures they took to ensure the truthfulness of the study. Although, these studies acknowledged

their limitations in the research process the use of measures would have ensured the accuracy of

the study.

Conclusion

The impact of smoke-free policies pertaining to the population of those affected by

mental illness is found throughout the different studies. The evidence supports a smoke free

policy has a positive impact on those who suffer from mental illness. It is noted that violence

related incidences declined, and the overall health of participants improved due to the policy

(Hehir, 2012, Hehir, 2013, Huddlestone, 2018, Metse, 2016, & Smith, 2019).Throughout all the

studies the use of stratified sampling is the method in which was used. A majority of the studies

relied on the quantitative methodological approach to conduct the research. As different data

collection methods exist the study is allowed to utilize the method that will best benefit the

study. The data collection that was commonly used throughout the studies was surveys and

interviews (Hehir, 2012, Huddlestone, 2018, & Metse, 2016). Analytical techniques are essential

in the analysis of data to provide the supporting evidence necessary to prove if the concept of the

researchers is accurate or not. Measures in studies are provided to ensure the validity and
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reliability of the study. All of these aspects are crucial to evaluate in a methodological literature

review.
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References

Hehir, A. M., Indig, D., Prosser, S., & Archer, V. A. (2012). Evaluation of a smoke-free forensic

hospital: Patients’ perspectives on issues and benefits. Drug & Alcohol Review, 31(5),

672–677. https://doi-org.summit.csuci.edu/10.1111/j.1465-3362.2012.00456.x

Hehir, A. M., Indig, D., Prosser, S., & Archer, V. A. (2013). Implementation of a smoke-free

policy in a high secure mental health inpatient facility: staff survey to describe experience

and attitudes. BMC Public Health, 13(1), 1–8. https://doi-

org.summit.csuci.edu/10.1186/1471-2458-13-315

Huddlestone, L., Sohal, H., Paul, C., & Ratschen, E. (2018). Complete smokefree policies in

mental health inpatient settings: results from a mixed-methods evaluation before and after

implementing national guidance. BMC Health Services Research, 18(1), N.PAG.

https://doi-org.summit.csuci.edu/10.1186/s12913-018-3320-6

Metse, A. P., Wiggers, J., Wye, P., Moore, L., Clancy, R., Wolfenden, L., … Bowman, J. A.

(2016). Smoking and environmental characteristics of smokers with a mental illness, and

associations with quitting behaviour and motivation; a cross sectional study. BMC Public

Health, 16(1), 1–11. https://doi-org.summit.csuci.edu/10.1186/s12889-016-2969-1

Smith, C. A., McNeill, A., Kock, L., & Shahab, L. (2019). Exploring mental health

professionals’ practice in relation to smoke-free policy within a mental health trust: a

qualitative study using the COM-B model of behaviour. BMC Psychiatry, 19(1), 1–12.

https://doi-org.summit.csuci.edu/10.1186/s12888-019-2029-3