On first impression, moves to ban smoking from its last bastion at Palmerston North Hospital - the mental health ward - seem a bit pedantic and mean-spirited.
Surely these patients have enough of a battle on their hands that kicking their cigarette habit is the last thing they need to worry about. Right?
But on closer inspection, the old thinking of nicotine as a form of stress management gives way to acknowledgement of medical evidence that shows, like most vices, nicotine increases stress and anxiety levels and ultimately does more harm than good for people suffering from mental illness.
MidCentral District Health Board's smokefree policy is an honourable, positive ambition, so long as it's sympathetically implemented, as it appears to be, and the patients' needs remain paramount.
The latter is the crux of contention.
Support worker Dean Black has expressed concern that MidCentral's plans are putting an idealistic philosophy ahead of the wellbeing of individual patients.
Smoking can be a crucial coping mechanism for patients in hospital, more so than when they're in the community, Black said. "I'd like to see it remain as a smoking area solely because it would help them with recovering quickly and moving out to community-based recovery, which is much more efficient than being in the ward," he argued.
It's a rationale any smoker or ex-smoker, regardless of their mental state, can appreciate. When not much is going your way, substantial solace can be sought and found in a fresh pack and a naked flame.
But focusing on short term relief is often at the expense of long term recovery.
The Mental Health Foundation backs strong evidence that smoking increases stress and anxiety and the likelihood of developing depression, anxiety disorders and other mental illnesses.
Likewise, research shows smoking cessation reduces stress and anxiety, and is associated with reduced rates of panic attacks and suicidal thoughts.
It would be incongruous if such a policy position was not backed up with concurring practices inside mental health units.
Patients who are able to leave the ward and wish to smoke in public places still can, and it's sensible that staff will help accommodate this. But while they are on hospital grounds there should be no mixed messages.
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