Includes bibliographical references and index.

It is well known that smoking is harmful to health. Smoking has steadily declined in the general population, but smoking rates for people with mental health needs have remained high. Stopping smoking is the most effective way of extending life expectancy and improving quality of life for people with mental health needs. National Institute for Health and Care Excellence recently published guidance that sets out a framework requiring mental health services to become completely smoke free across all sites. Service users are to be provided with specialist support to manage withdrawal from tobacco and abstain from smoking during inpatient admissions. This is a major change for mental health service providers. Staff "buy-in" to such a major change is an important aspect of successful implementation, yet little is known about the views of staff regarding the prospect of implementing this guidance. This study involved four National Health Service mental health trusts and is part of a 4-year project. Using a survey, the study aimed to benchmark the smoking status of the workforce in each trust and ascertain their views on smoke-free mental health services. The emphasis of the study was to provide each participating trust with local information to support their implementation process. This case study describes the research process used and the challenges faced in designing and conducting this study across four large organizations.

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