Smoke gets in your eyes, hair, socks and underwear....

July 1 2007 England: at last smoke free indoor public spaces!

I don't smoke. Hate cigarettes, but not people who smoke.

I've seen cigarettes used to control patients in the past and seen the effects on people when if the supply of cigarettes was not 'managed' then major problems ensued.

Both patients, staff and nicotine were well and truly locked in an institutionalised embrace. This relationship was strongest in the old mental health institutions on the long-stay (or 'rehab' wards).

I used to arrive home from work and ALL my clothes absolutely reeked of cigs. Into the shower. Nausea as the water ran over my hair.

As I prepare to return to work in the community: on home visits if someone goes to light up, I beg their pardon and acknowledge that I am a guest in their home - but could they please possibly hold-on a while. This isn't just a strategy to shorten visits. The first lesson of first aid is DO NOT become the next casualty. I also take the role of health promotion seriously. When people put the smokes away, I thank them on leaving highlighting the great favour granted to me. In summer and sometimes winter - their addiction helps me to help them - an excuse for us to venture outside to have a walk: ecotherapy! If people value your input, most do not mind. They also remember for next time - so social skills are employed. If needed though in the car I have a jacket just for the 'smoky visits'.

Cigarettes have been the cause of so many problems on wards resulting in aggressive behaviour.

Before I start sounding holier-than-thou - one of the worst instances was an elderly gentleman on a then 'psycho-geriatric' ward who with no smokes was livid. He wielded his zimmer walking frame at staff. We sorted the problem, calmed him down and no one was hurt; but the distress caused to this gentleman and many others over decades....

IF there is a benefit to be associated with cigarettes it's teaching the art of anticipating a person's needs and differentiating between the person and their behaviour.

An organic, naturally occurring pesticide must be bad for you and that's just one of the poisons in a cigarette (a regular chemical factory).

There is an established body of research on the links and effects between mental health, specific diagnostic groups and smoking. As for summer 2007 looking at the grey skies over the UK at present, many people WILL struggle. You have to wonder how referrals to all mental health services (primary and secondary care) will run over the next 12 months (next spring!) and how well we can monitor the effects?

Source: Nicotine molecule image (permission sought): Ron Perry and Sarah Frisken

P.S. To what extent have cigarettes affected human genetic development?