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Smoke-free Hospital Campuses

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Smoke-free Hospital Environments
Linda A. Thomas, MS
University of Michigan Health System
Tobacco Consultation Service
LEADING CAUSES OF DEATH
IN U.S.
Heart Disease
Smoking,
Cholesterol, Exercise
Cancer
Smoking
Emphysema
Smoking
Stroke
Hypertension,
Smoking
Smoking-Related Causes of
Increased Costs in the Workplace
Absenteeism
пЃ® Medical and Dental care costs
пЃ® Health insurance and life insurance costs
and claims
пЃ® Disability and premature mortality
 Worker’s compensation payments
пЃ® Accidents and fires
пЃ®
As much as 35 minutes per
smoker per day (or 18.2
days per smoker per year)
is lost on smoking and
smoking rituals.
Excess absenteeism costs an
employer an estimated $330
extra a year for each smoker
on the payroll.
Recovery room stays are longer
for smokers than nonsmokers
The charges for a longer stay in
the recovery room are at least
20% higher for smokers than for
nonsmokers
Patients who smoke regularly
before surgery have twice the risk
of wound infection as
nonsmokers
Smoking is the most common
cause of pulmonary morbidity
during surgery and anesthesia
The Problem
Over 440,000 deaths occur annually due to
tobacco use.
пЃ® The mission of health care facilities is at
odds with current practices.
пЃ® Movement to a smoke-free environment
requires significant change and
commitment.
пЃ®
Multi-Action Plan
Total ban on smoking both indoors and
outdoors.
пЃ® Identify and treat all admitted patients
who are tobacco users.
пЃ® Provide outpatient smoking cessation
for all patients, visitors, and
employees.
пЃ®
Pros for a
Smoke-free Environment
Sets a clear example of good health
practices.
пЃ® Puts employees, patients and guests first by
providing a healthy, smoke-free atmosphere.
пЃ® Lower clean up costs.
пЃ® Encourages both employees and patients to
quit tobacco use.
пЃ® Lower long-term health care cost.
пЃ®
Cons to a Smoke-free Campus
пЃ®
Creating a major cultural change
пЃ®
More difficult to implement due to
compliance problems
пЃ®
No place for the stressed, addicted smoker
to go
Obstacles
пЃ®
пЃ®
пЃ®
Hospitals
• tradition
• confrontation
• short-term interest
Insurance Plans
• turn over of customers
• up front cost
Physicians
• reimbursement
• lack of education
Obstacles
Employees
пЃ® Risk Management/Security
пЃ® Dying Patients
пЃ® Psychiatric Unit
пЃ® Family member stress
пЃ® Patient rights
пЃ® JCAHO
пЃ® Unions
пЃ®
First Steps to Implement SFE
пЃ® Change
attitudes
пЃ® Change
people’s roles
пЃ® Change
standards of health care
A Checklist for Action
пЃ® Announce
top management’s
commitment to creating a SFE
пЃ® Create
task force to plan
implementation
пЃ® Develop
a timetable
A Checklist for Action (con’t.)
пЃ®
Gather information
• Medical, economic and social effects of
smoking
• Smoke-free policies of other
organizations
• Facility questions
• Employee positions
• Your institution’s existing policy
• Legal issues
A Checklist for Action (con’t.)
пЃ® Draft
an implementation plan
пЃ® Announce policy and
implementation plan to
all employees from
leadership
Educate employees, patients, and guests
A Checklist for Action (con’t.)
пЃ® Make
changes to facilitate SFE.
пЃ® Enforce
the policy.
пЃ® Evaluate
and refine policy.
• Be flexible
• Be patient
Enforcement
Supportive
пЃ® Clear definition of smoke-free area
пЃ® Intervention cards
пЃ® Signage
пЃ® Employee compliance
пЃ®
• Patients and guests follow the example of your
employees
• Consistent policy for all staff
• Whatever your policy, enforce it
UMHS Lessons Learned
Implement a policy you can enforce
пЃ® Remember this policy is like hand washing or
parking issues
пЃ® Never assume you have communicated
enough
пЃ® Enforcement happens
пЃ®
• Be clear, be consistent, start from the beginning
Patience is a virtue
пЃ® Repetition, Repetition, Repetition
пЃ®
Want more assistance?
There is free assistance to those hospitals
who wish to go smoke-free. There is a CD
and consultants available to assist.
For more information call Linda Thomas
at 734-936-5988
Funding for this project provided by the
Michigan Department of Community HealthTobacco Section
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