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Fernane A, Saetta S, Trichard C, Minary L, Remen T, Martini H, Guirimand N, Rouquette A, Amsellem N, Lombrail P, Leplège A, Groupe Tabapsy. Smoking and mental disability : A mixed observational study using a diverse sample of medical-social establishments and services. Sante Publique 2024; 36:33-44. [PMID: 38580465 DOI: 10.3917/spub.241.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
INTRODUCTION A multi-center observational study was carried out in ten ESMS, using a mixed methodology (site visits, questionnaire survey, semi-directive group interviews with professionals and individual interviews with users). PURPOSE OF THE RESEARCH The aim of this article is to describe the management and prevention of smoking in ESMS for people with mental health disorders, and to characterize and identify the smoking behaviors and representations of ESMS users and the professionals working there. RESULTS The study made it possible to distinguish between ESMS in terms of the organization of smoking areas and tobacco prevention initiatives. It also revealed that 37 percent of respondents among the professionals said they smoked tobacco, with some of them explaining that they smoked with users and sometimes gave them cigarettes. With regard to prevention, there was a consensus among professionals that they should help users who wanted to stop smoking. Professionals were divided, however, on the need for more active prevention, citing the users’ freedom and the fact that ESMS are places where people live. Among the users, 47 percent said they were smokers. Of the users who smoked, 55 percent said they wanted to stop. Interviews with the users revealed that twelve of them wanted to quit, with some asking for help and more assistance from professionals. CONCLUSIONS This report suggests that intervention research could be developed in ESMS for people with mental health disorders, who could benefit from the smoking prevention actions identified in the facilities and services investigated.
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Affiliation(s)
- Adel Fernane
- Directeur d’établissement social et médico-social, ingénieur d’études ; plateforme de recherche sur la santé mentale et le handicap psychique (PRSM-HP), France
| | - Sébastien Saetta
- Chercheur ; ENSEIS Recherche, PRSM-HP, CHU de Saint-Étienne, Centre Max-Weber UMR 5283, France
| | | | | | | | - Hervé Martini
- Addictologue ; Association Addictions France, France
| | | | - Alexandra Rouquette
- Professeur des universités, praticien hospitalier ; université Paris-Saclay, CESP U1018 INSERM, France
| | | | - Pierre Lombrail
- Professeur émérite ; université Sorbonne-Paris-Nord, LEPS (laboratoire éducations et promotion de la santé), France
| | - Alain Leplège
- Professeur des universités ; université Paris-Cité, SPHERE UMR 7219, PRSH-HP, France
| | - Groupe Tabapsy
- L’étude présentée dans cette contribution a été portée par la PRSM-HP et s’est appuyée sur un groupe de travail impliquant les acteurs de terrain. Ce groupe, le groupe TABAPSY, était constitué des personnes suivantes : Madeleine Bata (Fondation des Amis de l’Atelier) ; Céline Blazy (Fondation des Amis de l’Atelier) ; Clémence Braem (Vivre et Devenir) ; Marie-Pierre Coret (Fondation l’Élan retrouvé) ; Caroline Cottin (Adef Résidences) ; Marie Delaroque (Vivre et Devenir) ; Lionel Demay (Adef Résidences) ; Angélique Guillon (Adef Résidences) ; Sonia Kongbo (AEDE) ; Natacha Ledjam (APSI) ; Marilyne Leterme (AEDE) ; Bruno Marques (Fondation l’Élan retrouvé) ; Jean-Alexandre Martins (Fondation l’Élan retrouvé) ; Anna Morgante (Fondation des Amis de l’Atelier) ; Michel Moulin (Fondation l’Élan retrouvé) ; Catalin Nache (APSI) ; Catherine Sanz (établissement public de santé Barthélemy-Durand) ; Jessica Thirolle (Fondation l’Élan retrouvé) ; Françoise Villemain (établissement public de santé Barthélemy-Durand)
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Saetta S, Frohlich KL, Le Dref G, Kivits J, Minary L. The (De)normalisation of Smoking Among Apprentices: Plurality of Settings, Norms and Vulnerability Levels. Qual Health Res 2024; 34:473-486. [PMID: 37173861 DOI: 10.1177/10497323231166796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
When it comes to smoking, apprentices are considered a 'vulnerable' population. They have been the subject of targeted approaches based on the assumption of common characteristics. In contrast to most public health studies, that assume homogeneity of vulnerable groups, this article, based on Lahire's 'theory of the plural individual', aims to examine inter- and intra-individual variability in relation to tobacco exposure. It is based on a secondary analysis of 30 interviews with apprentices in France on the stigma attached to their use in their different living environments. Our study confirms that the family and the Centre de Formation des Apprentis, as a whole, encourage smoking. It also provides a better understanding of the mechanisms by which inequalities are perpetuated (permissive rules, loans and gifts of cigarettes, spillover effects, lack of incentives to quit). Nevertheless, it allows us to observe that, in some families and in some companies, smoking is denormalised, even stigmatised. Several apprentice profiles emerge: those who are protected from tobacco and seem to be able to quit easily; those who are permanently confronted with it and for whom it is difficult to consider quitting or reducing; and those who are confronted with a plurality of norms, who seem ambivalent and whose consumption varies significantly. These results will allow us to adapt the interventions according to the profile of the apprentices and by including their entourage. In particular, it will be necessary to propose a 'go-to' approach that goes beyond the school setting and involves the family and the workplace.
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Affiliation(s)
- Sébastien Saetta
- ENSEIS Recherche, ENSEIS, Villeurbanne, France
- UMR 5283 Centre Max Weber, Lyon, France
- EA4360 APEMAC, University of Lorraine, Nancy, France
| | - Katherine L Frohlich
- School of Public Health, University of Montréal, Montréal, QC, Canada
- CReSP, University of Montréal, Montréal, QC, Canada
| | | | - Joëlle Kivits
- EA4360 APEMAC, University of Lorraine, Nancy, France
- Université Paris Cité, Inserm, ECEVE, F-75010 Paris, France
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Saetta S, Coldefy M, Degry J, Lanquetin JP, McCardell A, Moreau D, Mougeot F, Quenum Y, Ropers P, Rohr L, Rostirolla D, Velpry L. [PLAID-Care: Research into the reduced use of coercion in France]. Encephale 2023:S0013-7006(23)00050-7. [PMID: 37127482 DOI: 10.1016/j.encep.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/09/2023] [Accepted: 03/20/2023] [Indexed: 05/03/2023]
Abstract
The use of coercion is a common practice in psychiatry despite its deleterious effects and insufficient evidence of benefits. It is so deeply rooted that the mention of establishments that make little use of it arouses a form of incredulity. However, the history of psychiatry and the international literature provide numerous examples of a psychiatry that is hardly coercive and numerous experiences of a reduction in the use of seclusion and/or restraint in psychiatric facilities. Today, in France, there are also less coercive establishments, which, for example, do not use mechanical restraint, have all their units open, or have reduced their use of seclusion and restraint. With regard to the stated policy objectives of reducing the use of coercion, it is surprising that most of these facilities receive little attention. PLAID-Care research aims to contribute to the visibility and analysis of these institutions and the factors involved in the reduced use of coercion. While these factors have already been identified in the international literature, the research is based on the multiplication of disciplinary perspectives (nursing, sociology, anthropology, geography) and the mobilization of a multi-level analytical framework that allows us to embrace their multiplicity and better understand their articulation. The originality of the research also lies in its historical dimension, which allows us to understand, on the scale of an institution, how a policy and practices aiming at the least recourse emerge and are consolidated. The project timeline is divided in three tasks: firstly, an inventory of "low-coercion" facilities in France; secondly, we will select and research four traditionally "low-coercion" facilities in France; thirdly we will focus on recently emerged "low-coercion" practices. PLAID-Care aims to revitalize French research on this theme which to date has been relatively lagging behind the numerous international studies. It will bring together and articulate the knowledge, tools and forms of organization and collaboration that contribute to making a policy of lesser use of coercion operational.
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Affiliation(s)
- Sébastien Saetta
- École nationale des solidarités, de l'encadrement et de l'intervention sociale (ENSEIS)-Siège, 185, rue Jean-Voillot, 69100 Villeurbanne cedex, France; Centre Max Weber (UMR 5283), 69007 Lyon, France; CHU de Saint-Étienne, pôle de psychiatrie, 42270 Saint-Priest-en-Jarez, France.
| | - Magali Coldefy
- Institut de recherche et documentation en économie de la santé (Irdes), 75019 Paris, France
| | - Julien Degry
- Université Jean-Monnet, 42023 Saint-Etienne Cedex 2, France
| | - Jean-Paul Lanquetin
- CHU de Saint-Étienne, pôle de psychiatrie, 42270 Saint-Priest-en-Jarez, France
| | | | - Delphine Moreau
- École des Hautes Études en santé publique, 35043 Rennes, France; Arènes (UMR 6051), 35700 Rennes, France
| | - Frédéric Mougeot
- École nationale des solidarités, de l'encadrement et de l'intervention sociale (ENSEIS)-Siège, 185, rue Jean-Voillot, 69100 Villeurbanne cedex, France; Centre Max Weber (UMR 5283), 69007 Lyon, France
| | - Yvonne Quenum
- CHU de Saint-Étienne, pôle de psychiatrie, 42270 Saint-Priest-en-Jarez, France
| | - Perrine Ropers
- École des Hautes Études en santé publique, 35043 Rennes, France
| | - Loïc Rohr
- CHU de Saint-Étienne, pôle de psychiatrie, 42270 Saint-Priest-en-Jarez, France; Centre hospitalier Saint-Jean de Dieu de Lyon, 69008 Lyon, France
| | - Daria Rostirolla
- École nationale des solidarités, de l'encadrement et de l'intervention sociale (ENSEIS)-Siège, 185, rue Jean-Voillot, 69100 Villeurbanne cedex, France
| | - Livia Velpry
- Université Paris 8, 93200 Saint-Denis, France; Centre de recherche médecine, sciences, santé, santé mentale, société (Cermes 3), 94800 Villejuif, France
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Quenum Y, Pulcini M, Morel-Prieur C, Saetta S, Fakra E. Deinstitutionalisation, community-based care and coercion: Did France learn from international experiences? Encephale 2023; 49:209-210. [PMID: 36775762 DOI: 10.1016/j.encep.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- Y Quenum
- Pôle universitaire de Psychiatrie, CHU de Saint-Étienne, Saint-Étienne, France.
| | - M Pulcini
- Pôle universitaire de Psychiatrie, CHU de Saint-Étienne, Saint-Étienne, France
| | - C Morel-Prieur
- Pôle universitaire de Psychiatrie, CHU de Saint-Étienne, Saint-Étienne, France
| | - S Saetta
- Pôle universitaire de Psychiatrie, CHU de Saint-Étienne, Saint-Étienne, France
| | - E Fakra
- Pôle universitaire de Psychiatrie, CHU de Saint-Étienne, Saint-Étienne, France; Equipe PsyR2-Centre de Recherche en Neurosciences de Lyon (CRNL), Inserm U1028 - CNRS UMR 5292, Université Jean Monnet St-Etienne- University Lyon 1, Lyon, France
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Saetta S, Kivits J, Frohlich K, Minary L. Stigmatisation et santé publique : le côté obscur des interventions anti-tabac. Sante Publique 2021; 32:473-478. [PMID: 35724162 DOI: 10.3917/spub.205.0473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Tobacco control strategies, considered legitimate and effective, are rarely the subject of critical analysis in France. This is specifically true with regard to their potentially harmful effects, particularly against people who continue to smoke. This article introduces this debate, focusing on the potentially stigmatizing effects of anti-smoking policies. It has been attested by numerous international studies, and by a study in France, that the general process of tobacco denormalization has led to the stigmatization of smokers who then may be subject to discrimination. To the extent that smoking is now concentrated in the most disadvantaged socio-economic populations in France, the latter are thus more exposed to stigma. While underscoring the need to develop targeted interventions against them, this article also warns and calls for vigilance regarding the potential iatrogenic effects of these interventions. It is therefore necessary to develop research and evaluations on this subject in order to accurately measure the effects of these interventions, particularly in terms of stigmatization and self-stigma, and to ensure that public health actors do not generate more problems than they solve.
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