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It has been suggested that despite the smoking ban, psychiatric wards have been falling through the loop-hole. The Mental Health Foundation has discovered that only a minority of UK psychiatric facilities have managed to successfully implement the smoking ban.

Of 109 mental health professionals, 85% said that they felt the ban had not been implemented effectively. Many said that it was difficult to stop patients smoking as there were no safe outdoor spaces where patients could smoke, while others said that patients smoked in secret, with staff turning a blind eye, especially when patients were extremely ill. In places where there is an outdoor space, staff said that escorting patients to this area was a drain on resources and staff time.

Staff said that enforcing the ban made them feel uncomfortably like policemen and reported that often they had to deal with patients reacting aggressively when asked to stop smoking. However when patients were allowed to smoke illicitly, the problem of fire hazards due to covert smoking and poorly-disposed cigarette butts arose.

A spokesperson from the mental health charity Mind pointed out that demanding that patients suddenly give up their habit when admitted to a psychiatric facility only compounded the stress and anxiety they would be likely to be experiencing. She said that people with mental health problems were twice as likely to smoke as the general public, so called for facilities to be better equipped to either support patients with quitting or provide them with areas where they could safely smoke.