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Implementing National Institute for Health and Care Excellence smoke-free guidance in a secure facility: an evaluation of the prescribing costs in clozapine users

  • Stephen Noblett (a1), Jane Beenstock (a1), James Noblett (a2), Joanne Ireland (a1) and Sarah Ormiston (a1)...
Aims and method

The increased rates of smoking in people with mental illness is well documented, and establishing smoke-free mental health environments has been emphasised over recent years. This article examines the financial costs of implementing smoke free guidance and assesses the cost associated with patients who were prescribed clozapine and who committed to stopping smoking cigarettes for the duration of the study period.


Patients (38) who were prescribed clozapine were included in the study. A moderate reduction in dose was noted with a moderate reduction in prescribing costs. The total increase in cost for the whole group, however, was £17 624, largely due to the use of nicotine replacement therapy and an increase in the number of clozapine assay tests.

Clinical implications

Further studies on implementing this important policy change are needed. The positive effects must be balanced with increased financial pressure on Mental Health Trusts.

Declarations of interest


Corresponding author
Correspondence to Stephen Noblett (
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BJPsych Bulletin
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Implementing National Institute for Health and Care Excellence smoke-free guidance in a secure facility: an evaluation of the prescribing costs in clozapine users

  • Stephen Noblett (a1), Jane Beenstock (a1), James Noblett (a2), Joanne Ireland (a1) and Sarah Ormiston (a1)...
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