Australia's leading anti-tobacco campaigner claims the NSW government has gone too far in forcing its outdoor smoking reforms onto vulnerable psychiatric patients held in public hospitals.
Ashley Coleman took his life in March after being granted an unsupervised cigarette break off-site from Liverpool Hospital's mental health unit - where smoking has been banned.
Now Coleman's distraught family have found an unlikely ally in renowned tobacco control lobbyist Simon Chapman, who has backed their call for a review of laws that force psychiatric patients to quit smoking when admitted.
Professor Chapman, who has won international awards for leadership in tobacco control, said he is in favour of ''dedicated smoking zones where people can go''.
''There are some important and under-discussed ethical issues in depriving people of their rights,'' he said. ''But somehow, when you are a patient, your rights to do as you please are suddenly suspended - even if you are not hurting other people.''
As a sufferer of schizophrenia, Coleman had been in and out of Liverpool Hospital's mental health unit for six years. Previously, he and other patients were able to smoke, under supervision, in a small, open-air courtyard next to the ward.
But under amendments passed by NSW Parliament last year, psychiatric patients across NSW are now confronted with a ''tobacco replacement program'', which includes nicotine patches, educational classes and, in rare cases, leave passes off-site.
Having presented himself to Liverpool Hospital in February, Coleman, 25, had remained in the mental health unit as an involuntary patient until March 30, when he was found dead at the nearby railway station after asking if he could leave the grounds for a cigarette.
''The system in place has failed,'' Coleman's father, Mark, said. ''The anti-smoking laws, as they stand, are too rigid.
''When people like my son are admitted, they are already suffering from conditions such as severe depression, anxiety issues and suicidal tendencies - without the added burden of suddenly being told they must quit. It seems cruel and unjust.''
He called on the O'Farrell government to show ''compassion''.
Family Drug Support founder Tony Trimingham is also campaigning for changes after witnessing the ''horror'' that was endured by an autistic and schizophrenic family member in Goulburn Hospital's mental health ward in October.
''All was fine until he wanted a cigarette and was told that policy now said he couldn't,'' he said.
Mr Trimingham said the situation triggered an ''emotional outburst'' which led to him being placed in ''total isolation'' for 48 hours.
''In most social settings, banning smoking is perfectly reasonable,'' he said. ''But when people have mental illnesses like these, it is ludicrous to enforce this sort of law.''
Anne Jones, chief executive of Action on Smoking and Health Australia, said mental health units were given a much longer period of time to go smoke-free and it would be a ''retrograde step'' if they returned to the ''bad old days''.
She said: ''There is overwhelming evidence that the health and treatment of people with psychiatric illnesses is significantly worsened if they smoke - and significantly improved if they quit.''
Health Minister Jillian Skinner declined to comment.
A Liverpool Hospital spokeswoman said its smoke-free policy mirrored NSW Health guidelines across the state.
''Inpatients are routinely assessed for nicotine dependency and offered appropriate advice and nicotine replacement therapy to manage withdrawal.''
She said it was wrong to imply inpatients were granted ''smoke breaks'' off-site.
''After careful assessment and, where clinically appropriate, mental health patients are granted escorted leave as part of their rehabilitation plan,'' she said. ''If patients respond well, they can be granted short periods of unescorted leave.''
For crisis support and suicide prevention services, phone Lifeline 13 11 14.
