title: Tobacco control policies in hospitals before and after the implementation of a national smoking ban in Catalonia, Spain.
abstract: BACKGROUND
  Diverse projects and guidelines to assist hospitals towards the attainment of comprehensive smoke-free policies have been developed. In 2006, Spain government passed a new smoking ban that reinforce tobacco control policies and banned completely smoking in hospitals. This study assesses the progression of tobacco control policies in the Catalan Network of Smoke-free Hospitals before and after a comprehensive national smoking ban.
  
  
  METHODS
  We used the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals to score the compliance of 9 policy standards (global score = 102). We used two cross-sectional surveys to evaluate tobacco control policies before (2005) and after the implementation of a national smoking ban (2007) in 32 hospitals of Catalonia, Spain. We compared the means of the overall score in 2005 and 2007 according to the type of hospital, the number of beds, the prevalence of tobacco consumption, and the number of years as a smoke-free hospital.
  
  
  RESULTS
  The mean of the implementation score of tobacco control policies was 52.4 (95% CI: 45.4-59.5) in 2005 and 71.6 (95% CI: 67.0-76.2) in 2007 with an increase of 36.7% (p < 0.01). The hospitals with greater improvement were general hospitals (48% increase; p < 0.01), hospitals with > 300 beds (41.1% increase; p < 0.01), hospitals with employees' tobacco consumption prevalence 35-39% (72.2% increase; p < 0.05) and hospitals that had recently implemented smoke-free policies (74.2% increase; p < 0.01).
  
  
  CONCLUSIONS
  The national smoking ban appears to increase tobacco control activities in hospitals combined with other non-bylaw initiatives such as the Smoke-free Hospital Network.
authors.affiliation: Tobacco Control & Research Unit, Cancer Prevention and Control Department, Institut Català d'Oncologia-IDIBELL, L'Hospitalet de Llobregat, Spain. cmartinez@iconcologia.net
authors.forename: Cristina
authors.initials: C
authors.lastname: Martínez
authors.forename: Marcela
authors.initials: M
authors.lastname: Fu
authors.forename: Jose M
authors.initials: JM
authors.lastname: Martínez-Sánchez
authors.forename: Montse
authors.initials: M
authors.lastname: Ballbè
authors.forename: Montse
authors.initials: M
authors.lastname: Puig
authors.forename: Montse
authors.initials: M
authors.lastname: García
authors.forename: Esther
authors.initials: E
authors.lastname: Carabasa
authors.forename: Esteve
authors.initials: E
authors.lastname: Saltó
authors.forename: Esteve
authors.initials: E
authors.lastname: Fernández
mesh_terms: D003430:Cross-Sectional Studies; D006761:Hospitals; D006801:Humans; D007882:Legislation, Hospital; D010564:Personnel, Hospital / Q000706:statistics & numerical data; D015397:Program Evaluation; D012907:Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence*; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention; D013030:Spain / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence* / Q000517:prevention & control
chemical_list: D014028:Tobacco Smoke Pollution