title: Do smoke-free environment policies reduce smoking on hospital grounds? Evaluation of a smoke-free health service policy at two Sydney hospitals.
abstract: OBJECTIVE
  To evaluate the compliance of hospital staff, inpatients and visitors with Sydney South West Area Health Service's Smoke-free Environment Policy.
  
  
  METHODS
  Six sites were observed at two Sydney hospitals 2 weeks before implementation of the policy and at 2 weeks, 6 months, 12 months, 18 months and 2 years after implementation.
  
  
  RESULTS
  There was an overall significant 36% (P≤0.05) reduction in observed smoking incidents on hospital grounds 2 years after implementation. Two years after implementation, observed smoking incidents reduced by 44% (P≤0.05) in staff, 37% (P≤0.05) in visitors and remained unchanged among inpatients.
  
  
  CONCLUSIONS
  The Smoke-free Environment Policy was effective in reducing visitors and staff observed smoking on hospital grounds, but had little effect on inpatients' smoking. Identifying strategies to effectively manage nicotine addiction and promote cessation amongst hospital inpatients remains a key priority.
authors.affiliation: Health Promotion Service, South Western Sydney and Sydney Local Health Districts, Narellan Community Health Centre, Narellan, NSW 2567, Australia. natasha.poder@sswahs.nsw.gov.au
authors.forename: Natasha
authors.initials: N
authors.lastname: Poder
authors.forename: Therese
authors.initials: T
authors.lastname: Carroll
authors.forename: Cate
authors.initials: C
authors.lastname: Wallace
authors.forename: Myna
authors.initials: M
authors.lastname: Hua
mesh_terms: D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006272:Health Facility Environment / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D006291:Health Policy; D006761:Hospitals / Q000592:standards* / Q000639:trends; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D009517:New South Wales; D016134:Organizational Policy; D010564:Personnel, Hospital / Q000706:statistics & numerical data / Q000639:trends; D012907:Smoking / Q000639:trends; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000517:prevention & control* / Q000706:statistics & numerical data; D014789:Visitors to Patients / Q000706:statistics & numerical data
chemical_list: D014028:Tobacco Smoke Pollution