OBJECTIVE: Individuals with mental health concerns are disproportionately affected by and suffer the negative consequences of @entity286 use disorder, perhaps because smoking has historically been part of psychiatry's culture. In the early 1990s, @entity146 inpatient facilities were exempted from U.S. hospital smoking bans, in response to public outcry with national media attention. Almost 2 decades later, the current study characterizes online conversation about @entity146 hospital smoking bans. Previous commenting studies have demonstrated commenting's negativity, documenting the "nasty effect" wherein negative comments color perceptions of neutral articles. Thus, we focused particular attention on cited barriers to implementing health-positive smoke-free policies. METHODS: We collected online comments (N = 261) responding to popular media articles on smoking bans in inpatient psychiatry between 2013 and 2014 and conducted an inductive and exploratory qualitative content analysis. RESULTS: Verifying previous studies documenting the prevalence of negative commenting, of the comments explicitly supporting or refuting psychiatry smoking bans, there were over twice as many con comments (n = 44) than pro (n = 18). Many commenters argued for access to outdoor smoking areas and warned of @entity1 @entity2146 and risk posed to care workers. Identified content themes included @entity146 medication and negative side effects, broken mental health systems and institutions, denigration of the health risks of @entity286 in the context of @entity1032 , typical pro-smoking arguments about "smokers' rights" and alternatives (including e-cigarettes), addiction, and stigma. CONCLUSIONS: The current findings provide a platform to begin to understand how @entity1 talk about mental health issues and smoking. Our analysis also raised complex issues concerning forces that impact U.S. @entity1 with serious @entity1032 but over which they have little control, including medication, the U.S. health system, stigma, perceptions that life with chronic serious @entity1032 is not worth living, and psychological and physical @entity158 of coping with @entity1032 . In consideration of identified barriers raised in opposition to smoking bans in inpatient psychiatry, efforts should emphasize @entity1 stakeholder involvement; @entity1 , visitor, and staff protection from smoke exposure; the effectiveness of @entity1239 replacement for managing withdrawal; and the lack of evidence that cigarettes are therapeutic.

Online comments on smoking bans in XXXX hospitals units.

@entity1 :: ('9606', 'Species') :: ['patients', 'people', 'patient'] @entity286 :: ('4097', 'Species') :: ['tobacco'] @entity1032 :: ('MESH:D008607', 'Disease') :: ['mental illness'] @entity146 :: ('MESH:D001523', 'Disease') :: ['psychiatric'] @entity1239 :: ('MESH:D009538', 'Chemical') :: ['nicotine'] @entity2146 :: ('MESH:D011595', 'Disease') :: ['agitation'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity146 :: (MESH:D001523,Disease) :: ['psychiatric']
