by Sheralyn Welch

Created on: March 29, 2009   Last Updated: April 03, 2009

On first thought, it seems ludicrous to think that any hospital would ever allow smoking; cigarettes are a direct cause of lung cancer, emphysema, and all manner of debilitating diseases. And it's safe to say that a great number of patients in hospitals are there as a direct result of years of smoking. Cigarettes kill the people hospitals are there to save.

But there is one part of many hospitals where not allowing patients to smoke sometimes does more harm than good: the psychiatric ward.

I'm not writing here about all patients in psychiatric wards or all people who are admitted to them. I'm writing about one in particular: my brother. He's been in and out of psych wards for most of his adult life, a victim of bipolar disease and atypical personality disorder. One of the hazards of his illness is that he is also prone to addiction, and that, unfortunately, includes cigarettes. In fact, there was one point when his cigarette habit had reached four packs a day.

During one downward spiral into the depths of his illness, my brother had to be hospitalized for several days; it was the only way, his psychiatrist said, that my brother could be stabilized and kept safe from committing suicide.

For the first couple of days, my brother was put on strong doses of anti-psychotic medication and was so disoriented, he didn't think about smoking. He seemed on the way to some kind of recovery. But by his third or fourth day in the hospital, he became more himself and suddenly, his craving for cigarettes became so intense, he couldn't sleep. As a patient, he wasn't allowed to smoke anywhere in the hospital; all the smokers in that ward had to leave their cigarettes with the staff, who would take the smokers out of the building once or twice a day to have one cigarette.

One or two cigarettes for a person who is used to smoking 80 is like not smoking at all. So here was my brother, once again battling the demons that have plagued him for years, faced with the added pain of having to withdraw from a serious addiction that held him tightly in its grip.

Under any circumstances, quitting smoking is extremely difficult. It requires concentration, focus, and enormous effort. But for someone who is fighting to stay sane, it is virtually impossible. For my brother, cigarettes were a way to stay calm; they were a crutch he needed to hold on to reality. On one of the nights I visited him in the hospital he told me that he couldn't stay in the hospital to get better because he absolutely had

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