title: Implementing a smoke-free medical campus: impact on inpatient and employee outcomes.
abstract: BACKGROUND
  Hospitals fear that transitioning to a smoke-free medical campus will decrease patient volume, particularly for patients who smoke. When our hospital campus, a 180-bed acute care facility located in a small town, implemented the smoke-free medical campus on July 1, 2006, we prospectively monitored inpatient and employee outcomes.
  
  
  METHODS
  Inpatient volume, percentage of inpatients who currently smoke, nicotine replacement therapy (NRT) orders (obtained from electronic medical records), the number of inpatients who signed out against medical advice (obtained from incident reports), and employee tobacco-use rates from annual occupational health assessments were compared pre-ban and post-ban.
  
  
  RESULTS
  The monthly average for the percentage of inpatients who currently smoke has been steady, at 20% to 22% post-ban. NRT orders tripled after the ban. There was no significant change in the rate of inpatients who signed out against medical advice pre-ban and post-ban. During the year preceding the ban, 150 employees participated in a cessation program offered by Employee Health. The pre-ban employee self-reported smoking rate for the same 4-month period (March-June) was 14.3% in 2005, 14.8% in 2006, and 9% in 2007 (P < 0.0002).
  
  
  CONCLUSIONS
  Implementing a smoke-free medical campus did not adversely affect inpatient volume (even among smokers), significantly increased inpatient NRT use, and decreased hospital employee smoking rates.
authors.affiliation: Research Institute, Bassett Healthcare, Cooperstown, New York 13326, USA. anne.gadomski@ bassett.org
authors.forename: Anne M
authors.initials: AM
authors.lastname: Gadomski
authors.forename: Marti
authors.initials: M
authors.lastname: Stayton
authors.forename: Nicole
authors.initials: N
authors.lastname: Krupa
authors.forename: Paul
authors.initials: P
authors.lastname: Jenkins
mesh_terms: D006764:Hospitals, Community; D006801:Humans; D016134:Organizational Policy; D015397:Program Evaluation; D011446:Prospective Studies; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000517:prevention & control
chemical_list: D014028:Tobacco Smoke Pollution