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Key Statistics 59.6% of staff disagreed with smoke-free policy on wards 57.4% disagreed with smoke-free policy throughout mental health settings Clinicians showed significantly lower organisational policy support than non-clinicians Particularly Concerning Aspects Professional Divide: Clinicians were less supportive than non-clinical staff Only psychiatrists showed strong support compared to nurses and allied health professionals This suggests those with the most direct patient contact were least supportive Cultural Entrenchment Study was conducted before mandatory implementation in 2018 Shows deep-rooted resistance to evidence-based policy Reflects continuing institutional acceptance of harmful behaviour Staff Smoking Impact: Current smokers showed significantly less positive attitudes This affected both organisational policy support and staff practice views Suggests personal smoking status influences professional judgment Training Effect: Those with smoking cessation training showed more positive attitudes However, the study suggests training may simply reinforce existing positive attitudes rather than changing negative ones This indicates a potential selection bias in who seeks training The findings are particularly troubling because they show resistance to change even as the evidence base for smoking harm in mental health populations has grown stronger, as documented in both this study and the 2008 paper cited earlier