Introduction:
Tobacco has usually been a neglected topic in the field of mental health, despite the high mortality it causes in this population. The aim of this study was to describe tobacco control strategies in hospital wards and mental health day centers in Catalonia, regardless its affiliation to the Catalan Network of Smoke-free Hospitals (XCHsF), to identify areas of improvement and to compare the results with those obtained a decade ago.

Material and Methods:
Repeated cross-sectional study with the same methodology in 2009 and 2020. An electronic questionnaire of 24 items covering 4 dimensions (intervention; staff training and commitment; control of smoke-free spaces; tobacco policy communication) was sent to all heads of mental health units in Catalonia. We obtained 186 (96.9%) responses in 2009 and 208 (98.1%) responses in 2020.

Results:
The number of mental health care centers that joined the XCHsF has increased (43% vs 76.4%; p<0.05) between 2009 and 2020, same as the mental health professionals that are members of the Smoke-free Project Committee (37.9% vs 86.6%; p<0.05). An improvement is observed in the dimensions "intervention" (always/often intervene in tobacco use from 34.7% to 72.6%; p<0.05) and "control of smoke-free spaces" (no indoor smoking spaces from 59.5% to 84.7%; p<0.05). The child/youth units have not increased their score in any dimension. 84.3% of heads agree that funding drugs to stop smoking would encourage patients to try quitting and the majority believe that the Tobacco Legislation (Law 42/2010) has helped to improve tobacco control and intervention in their unit.

Conclusions:
Smoking control and interventions have increased in the last decade in mental health units in Catalonia after the Spanish Law 42/2010. Efforts must be done especially in the children/youth mental services. Continued monitoring areas for improvement, promoting interventions and training health professionals are warranted.