Professor Richard Ashcroft is quoted in an article in The Lancet on the ‘firmly entrenched culture of smoking’ that prevails at in-patient secondary care facilities for those with mental health problems. He says: “There's a sense in some places that the major health need of the mental health patient is their mental disorder, and that smoking is not worth making a fuss over. Cigarette breaks can also form a kind of currency between healthcare workers and patients.”