Smoke free hospital campus Strong positive shift in attitudes post implementation but paradox in nursing and medical attitudes

Abstract

Background This paper is a report of a study of acceptance by patients and staff of a hospital campus-wide smoking ban one year post-introduction, in order to determine if there was a shift in attitude, and staff perception of their individual roles in implementation. The survey also investigates the smoking rates of patients and staff. Method Survey of both patients and staff in a tertiary referral university hospital in Ireland. Interviewer-delivered questionnaire survey of all inpatients on single day and sample of staff (10% in each occupational group); comparison with 2006 preimplementation survey. Results There was a significant fall in smoking rates between 2006 and 2010 in staff (17.8% v 10.7%;p=0.02) but not in patients (22.7% v 18%; p>0.05). Positive attitude of patients (58.6% v 84.2%, p<0.001) and staff (52.4% v 83.3%, p<0.001) to the campus-wide ban increased significantly between 2006 and 2010; the greatest increase was seen in doctors. When perception of own role in implementation was examined, younger staff were less likely to agree they had a role, while ex-smokers were more likely. Among the occupational groups, nurses were significantly more likely to agree than all other groups, including medical doctors. Conclusion Documented significant positive change in attitudes to a campus-wide smoking ban; opposite attitudes of doctors and nurses to ban and to role in implementation. Despite documented challenges internationally, for long-term success a commitment from all staff to implementation is critically important.