title: Employee attitudes about moving toward a smoke-free campus at a Veterans Affairs hospital.
abstract: BACKGROUND
  Although Veterans Affairs (VA) hospitals have been smoke-free inside of buildings since 1991, smoke-free campuses have not been initiated. The purpose of this article is to describe staff attitudes regarding making the VA hospital a smoke-free campus except for the mandated smoking shelters.
  
  
  METHODS
  In 2008, a cross-sectional, anonymous survey was conducted with a convenience sample of employees at a Midwestern VA (N = 397).
  
  
  RESULTS
  Descriptive statistics showed that the vast number of employees were in support of a smoke-free campus (76%), relocating the smoking shelters (62%), and offering employees assistance to quit smoking (71%). Multivariate analyses showed that those who were nonsmokers, older, women, and higher educated were the greatest supporters of policies to support a smoke-free environment (p < .05). Write-in comments were generally favorable but also revealed employee resistance related to freedom, personal choice, and potential loss in productivity as smokers go further away from the building to smoke.
  
  
  CONCLUSIONS
  VA hospitals have unique challenges in implementing smoke-free campus policies.
authors.affiliation: Sonia A. Duffy, PhD, RN, FAAN, VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, and School of Nursing and Departments of Otolaryngology and Psychiatry, University of Michigan, Ann Arbor. Lee A. Ewing, MPH, and Deborah E. Welsh, MS, BA, VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan. Petra S. Flanagan, PharmD, Stacey B. Breedveld, RN, MSN, and Eric W. Young, MD, VA Ann Arbor Healthcare System, Ann Arbor, Michigan. Andrea H. Waltje, RN, MS, School of Nursing, University of Michigan, Ann Arbor.
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Duffy
authors.forename: Lee A
authors.initials: LA
authors.lastname: Ewing
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Welsh
authors.forename: Petra S
authors.initials: PS
authors.lastname: Flanagan
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Waltje
authors.forename: Stacey B
authors.initials: SB
authors.lastname: Breedveld
authors.forename: Eric W
authors.initials: EW
authors.lastname: Young
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002648:Child; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006787:Hospitals, Veterans / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016272:Occupational Health; D009936:Organizational Innovation; D016134:Organizational Policy; D036301:Qualitative Research; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D000074606:Smoking Prevention; D014481:United States; D014493:United States Department of Veterans Affairs