In an excellent article about two Canadian hospitals that are failing to provide effective and compassionate care for patients who smoke, Schultz and colleagues1 note that many patients do not have access to nicotine replacement therapy and must risk leaving the hospital grounds to smoke.
“No smoking” policies are effective in places that smokers can choose to avoid (e.g., restaurants) or to visit only for a short time (e.g., banks), but such policies are inappropriate for hospitals, where smokers may be confined for days. Simplistic smoking bans seem ineffective and punitive. Many smokers are addicted to tobacco and cannot quit without assistance.
Hospitals need safe, well-ventilated, designated smoking areas for inpatients. These areas should include centres that offer treatment for tobacco addiction and provide helpful resources that could include the following:
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Televisions (with multilingual audio tracks and subtitles) looping information and inspirational messages from smokers who have quit
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Posters, booklets and pamphlets about smoking cessation
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Telephone hotlines to the Smokers’ Helpline and to a hospital resource person, perhaps a pharmacist, who could ensure 24/7 access to nicotine replacement and could arrange an appointment with a smoking cessation counsellor
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Dispensing machines for nicotine replacement products
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Computers with access to smoking cessation resources
If such changes were to be implemented, we could consider ourselves health care workers who are treating patients for addiction. Until then, we are acting as sadistic jailers of innocent victims of the tobacco industry.