PSY-Smokestop: Smoking Cessation in Psychiatric Care – A Model Project

In psychiatric settings, smoking prevalence among both staff and patients is substantially higher than in the general population. While approximately one quarter of the Swiss population smokes, rates among psychiatric patients range from 50% to 90% depending on the setting. At the same time, institutionally embedded, systematically implemented tobacco cessation programmes are lacking. Smoking is frequently normalised in everyday clinical practice. Despite existing guidelines and pharmacological options, smoking cessation interventions are rarely offered in a structured manner. This project addresses this gap in care using the example of PDAG and develops a transferable model for psychiatric institutions across Switzerland.

The aim is to sustainably establish smoking cessation as part of standard treatment and to foster a smoke-free institutional culture in both inpatient and outpatient psychiatry. The project operates on four levels:

1. supporting staff who smoke in quitting
2. enabling clinical personnel to systematically deliver smoking cessation interventions for patients
3. structurally embedding tobacco prevention standards in clinical practice
4. preparing a scale-up to other psychiatric institutions.

At least 40% of smoking staff and patients are to be reached.  

The project follows a participatory, stepwise implementation approach. After a six-month preparatory phase involving workshops and focus groups, the programme is initially rolled out on two pilot wards (adult psychiatry and addiction disorders). Core components include:

• Training and continuing education for clinical staff
• Standardised smoking cessation algorithms (including motivational interviewing and pharmacological support)
• Low-threshold programmes for staff
• Adaptations to institutional framework conditions
• Continuous evaluation (including CO measurement and 3-month follow-up).
• This is followed by successive expansion to further inpatient and outpatient services at PDAG. 

The project closes a critical gap in psychiatric healthcare. It combines public health expertise with clinical practice and addresses health inequity affecting a particularly vulnerable population. By integrating individual support, structural changes, and institutional embedding, it creates a sustainable model programme with national reach. PSY-Smokestop can thus serve as a best-practice model for tobacco-preventive psychiatry in Switzerland.