A qualitative investigation of smoke-free policies on hospital property
- 31 October 2011
- journal article
- research article
- Published by CMA Impact Inc. in CMAJ : Canadian Medical Association Journal
- Vol. 183 (18), E1334-E1344
- https://doi.org/10.1503/cmaj.110235
Abstract
Background: Many hospitals have adopted smoke-free policies on their property. We examined the consequences of such polices at two Canadian tertiary acute-care hospitals. Methods: We conducted a qualitative study using ethnographic techniques over a six-month period. Participants (n = 186) shared their perspectives on and experiences with tobacco dependence and managing the use of tobacco, as well as their impressions of the smoke-free policy. We interviewed inpatients individually from eight wards (n = 82), key policy-makers (n = 9) and support staff (n = 14) and held 16 focus groups with health care providers and ward staff (n = 81). We also reviewed ward documents relating to tobacco dependence and looked at smoking-related activities on hospital property. Results: Noncompliance with the policy and exposure to secondhand smoke were ongoing concerns. Peoples’ impressions of the use of tobacco varied, including divergent opinions as to whether such use was a bad habit or an addiction. Treatment for tobacco dependence and the management of symptoms of withdrawal were offered inconsistently. Participants voiced concerns over patient safety and leaving the ward to smoke. Interpretation: Policies mandating smoke-free hospital property have important consequences beyond noncompliance, including concerns over patient safety and disruptions to care. Without adequately available and accessible support for withdrawal from tobacco, patients will continue to face personal risk when they leave hospital property to smoke.Keywords
This publication has 23 references indexed in Scilit:
- Failure of hospital employees to comply with smoke-free policy is associated with nicotine dependence and motives for smoking: a descriptive cross-sectional study at a teaching hospital in the United KingdomBMC Public Health, 2009
- Smoke-Free Medical Facility Campus Legislation: Support, Resistance, Difficulties and CostInternational Journal of Environmental Research and Public Health, 2009
- Smoking care provision in hospitals: A review of prevalenceNicotine & Tobacco Research, 2008
- Barriers and Challenges for Tobacco Control in a Smoke-Free HospitalCancer Nursing, 2008
- Smoke-free hospitals – the English experience: results from a survey, interviews, and site visitsBMC Health Services Research, 2008
- Hospitalized smokers: Compliance with a nonsmoking policy and its predictorsPreventive Medicine, 2006
- An ethnographic study of tobacco control in hospital settingsTobacco Control, 2006
- Smoking by Patients in a Smoke-Free Hospital: Prevalence, Predictors, and ImplicationsPreventive Medicine, 2000
- Qualitative analysis: What it is and how to beginResearch in Nursing & Health, 1995
- Achieving Smoke-Free HospitalsHospital Topics, 1993