Smoke-Free Medical Facility Campus Legislation: Support, Resistance, Difficulties and Cost

Christine Sheffer,Maxine Stitzer,J Gary Wheeler

doi:10.3390/ijerph6010246

Abstract

Although medical facilities restrict smoking inside, many people continue to smoke outside, creating problems with second-hand smoke, litter, fire risks, and negative role modeling. In 2005, Arkansas passed legislation prohibiting smoking on medical facility campuses. Hospital administrators (N=113) were surveyed pre- and post-implementation. Administrators reported more support and less difficulty than anticipated. Actual cost was 10–50% of anticipated cost. Few negative effects and numerous positive effects on employee performance and retention were reported. The results may be of interest to hospital administrators and demonstrate that state legislation can play a positive role in facilitating broad health-related policy change.

Highlights

Smoking, which causes over 438,000 deaths and $167 billion in costs annually, is the greatest source of preventable death and disease in the U.S [1,2,3]
The initial survey administration revealed some confusion on the part of the facilities as to whether the legislation applied to their facility or not
Anticipated level of resistance from physicians pre-implementation. This investigation provides the first quantified, experiential evidence regarding the widespread implementation of smoke-free medical facility campus policies with data collected systematically both pre- and post-implementation from a large sample of medical facilities undergoing the same process at the same time

Summary

Introduction

Smoking, which causes over 438,000 deaths and $167 billion in costs annually, is the greatest source of preventable death and disease in the U.S [1,2,3]. Smoke-free policies are an important component of an ecological and social-cognitive approach to reducing tobacco use and tobacco-related disease [4,5,6]. The U.S healthcare system has been slow to respond with comprehensive tobacco control policies [7]. Healthcare facilities serve as employers, healthcare providers, and community leaders and have greater responsibility than most in protecting people from tobacco smoke [8, 9]. Organizations (JCAHO) introduced indoor restrictions on smoking as a quality indicator [10]. These JCAHO requirements did not restrict smoking outside facilities.

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