Non-Smoking Policies in Hospitals

Abstract

yasa ? HY SI CIANS have responded dramatically to the evidence on the health hazards of smoking. In 1976, only 21% of American physicians reported themselves cigaP ~ 5 rette smokers (i), down from over 5o% some 30 years earlier. A small survey of Massachusetts physicians in 1980 showed that only 9% of those under 40 years of age smoked cigarettes (2). Among current medical students, smoking is estimated to be as low as 6% (3), suggesting that future physicians will almost all be nonsmokers. A survey of primary care practitioners indicated that 93% considered elimination of cigarette smoking to be "very important" in promoting health (4). Ninety-one percent of physicians surveyed in 1975 agreed that the members of the profession should set an example by not smoking (i), confirming a view long held by the public (S). The importance of the nonsmoking physician in influencing behavior in health care institutions has been experimentally demonstrated (6). But many hospitals where medical staff make policy decisions need yet to develop meaningful institutional policies regarding smoking. Ambulatory care centers and health maintenance organizations also need to devise policies on smoking. The actions of individual physicians, although vital, are not sufficient to convey a consistent non-smoking message from the medical community.