RT Journal Article
SR Electronic
T1 A qualitative investigation of smoke-free policies on hospital property
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E1334
OP E1344
DO 10.1503/cmaj.110235
VO 183
IS 18
A1 Annette S.H. Schultz
A1 Barry Finegan
A1 Candace I.J. Nykiforuk
A1 Margaret A. Kvern
YR 2011
UL http://www.cmaj.ca/content/183/18/E1334.abstract
AB 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.See related commentary by Lawn at www.cmaj.ca/lookup/doi/10.1503/cmaj.111579