Last update:
29-Sep-2025

Despite the smoking rate decline in the general population, no corresponding reduction has been observed in individuals with mental health conditions, with tobacco and related product use remaining prevalent among them. Implementing anti-smoking policies in this population is fraught with various challenges, complexities, and ethical dilemmas. High smoking rates, strong nicotine dependence, socioeconomic factors, low health literacy among mental health service users, and the attitudes of mental health professionals are all challenges to be addressed for effective intervention to occur. The implementation or non-implementation of anti-smoking legislation raises a series of ethical dilemmas and issues, such as respecting individual autonomy and freedom of choice, including the choice to smoke. It also poses the question of whether excluding smokers from decision-making processes reflects a paternalistic approach contravening a recovery-oriented approach. Implementing anti-smoking legislation in mental health units can be justified as a measure consistent with the ethical duty of beneficence, proactively protecting and improving public health. Additionally, the principle of justice, which dictates fair and equal treatment, underscores that failing to enforce anti-smoking policies perpetuates health and socio-economic inequalities. An ethical approach, however, ensures that smokers with mental disorders receive the support necessary to quit smoking, while also providing a smoke-free environment that promotes overall health and well-being, beneficial to both mental health staff and clients. Concluding, the persistently high prevalence of smoking among mental health disorder sufferers highlights the urgency of a regulatory framework addressing the specific needs of mental health service users. Such a framework ought to provide tailored support and personalized smoking cessation interventions. Continuous evaluation of these interventions is deemed crucial in addressing emerging challenges and ensuring their sustainability and long-term effectiveness.

Key words: Anti-smoking legislation, Mental health disorder, Smoking, Smoking cessation.