title: A qualitative investigation of smoke-free policies on hospital property.
abstract: BACKGROUND
  Many hospitals have adopted smoke-free policies on their property. We examined the consequences of such polices at two Canadian tertiary acute-care hospitals.
  
  
  METHODS
  We conducted a qualitative study using ethnographic techniques over a six-month period. Participants (n=186) shared their perspectives on and experiences with tobacco dependence and managing the use of tobacco, as well as their impressions of the smoke-free policy. We interviewed inpatients individually from eight wards (n=82), key policy-makers (n=9) and support staff (n=14) and held 16 focus groups with health care providers and ward staff (n=81). We also reviewed ward documents relating to tobacco dependence and looked at smoking-related activities on hospital property.
  
  
  RESULTS
  Noncompliance with the policy and exposure to secondhand smoke were ongoing concerns. Peoples' impressions of the use of tobacco varied, including divergent opinions as to whether such use was a bad habit or an addiction. Treatment for tobacco dependence and the management of symptoms of withdrawal were offered inconsistently. Participants voiced concerns over patient safety and leaving the ward to smoke.
  
  
  CONCLUSIONS
  Policies mandating smoke-free hospital property have important consequences beyond noncompliance, including concerns over patient safety and disruptions to care. Without adequately available and accessible support for withdrawal from tobacco, patients will continue to face personal risk when they leave hospital property to smoke.
authors: Psychosocial Oncology and Cancer Nursing Research Group, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba. annette_schultz@umanitoba.ca
authors: Annette S H
authors: AS
authors: Schultz
authors: Barry
authors: B
authors: Finegan
authors: Candace I J
authors: CI
authors: Nykiforuk
authors: Margaret A
authors: MA
authors: Kvern
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006761:Hospitals / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D012907:Smoking / Q000331:legislation & jurisprudence*; D016540:Smoking Cessation / Q000379:methods*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution