Effect of a smoke-free policy on staff attitudes and behaviours within an Australian metropolitan health service: a 3 year cross-sectional study
Nicole Hale A , Andrea M. Murphy A , Jon R. Adams A and Cylie M. Williams A B CA Peninsula Health Community Health, 2 Hastings Road, Frankston, Vic. 3199, Australia. Email: nhale@phcn.vic.gov.au; amurphy@phcn.vic.gov.au; healthpromotion@phcn.vic.gov.au
B Monash University, Faculty of Medicine, Nursing and Health Science, McMahons Road, Frankston, Vic. 3199, Australia.
C Corresponding author. Email: CylieWilliams@phcn.vic.gov.au
Australian Health Review 41(1) 7-12 https://doi.org/10.1071/AH15159
Submitted: 25 August 2015 Accepted: 18 February 2016 Published: 7 April 2016
Abstract
Objective In 2010, Peninsula Health (Vic., Australia), became smoke free as part of the locally developed smoking prevention and cessation strategy. The aim of the present study was to determine the effect of a smoke-free policy on smoking status and employee attitudes over a 3-year period.
Methods Data were collected by three surveys 6 months before and 6 months and 3 years after policy introduction. Demographic data, smoking status and attitudes to the introduction of the smoke-free policy were collected for analysis.
Results There were 3224 individual responses collected over three time points with similar demographics at each time. There were fewer employees smoking at 6 months (P = 0.010) and 3 years (P < 0.001) after implementation of the policy. There were more employees who felt positive towards the policy 3 years after its introduction (P = 0.028). There were greater odds of an employee not identifying as a smoker after the policy was in place than before the policy was implemented.
Conclusions The introduction of a smoke-free policy within a health service was an upstream health intervention that was well accepted by staff and appeared to have a positive effect on smoking behaviours.
What is known about the topic? There are an increasing number of environmental changes that seek to decrease smoking behaviours. Bans within workplaces have a direct effect on employee smoking behaviour.
What does this paper add? Some employee groups demonstrated the greater odds of smoking when a smoke-free policy was in place. Employees felt positive towards this policy.
What are the implications for practitioners? This policy change supports environmental changes affecting individual health-related behaviours.
Additional keywords: attitudinal change, health promotion, organisation, tobacco control, workplace policy.
References
[1] Australian Government. National tobacco strategy 2012–2018. Canberra: Australian Government; 2012.[2] Scollo MM, Winstanley MH. Tobacco in Australia: facts and issues. 4th edn. Melbourne: Cancer Council Victoria; 2012.
[3] Oberg M, Jaakkola MS, Woodward A, Peruga A, Pruss-Ustun A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 2011; 377 139–46.
| Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries.Crossref | GoogleScholarGoogle Scholar | 21112082PubMed |
[4] Letcher T, Borland R. Quit Victoria research and evaluation studies no. 11: 2000–2001. Melbourne: Centre for Behavioural Research in Cancer; 2003.
[5] Wheeler JG, Pulley L, Felix HC, Bursac Z, Siddiqui NJ, Stewart MK, Mays GP, Gauss CH. Impact of a smoke-free hospital campus policy on employee and consumer behavior. Public Health Rep 2007; 122 744–52.
| 18051667PubMed |
[6] Giraldi G, Fovi De Ruggiero G, Cattaruzza MS, Camilli F, Dionette P, Osborn JF, De Luca , d’Alessandrio E. Perception of smoke-free policies among workers in an Italian Local Health Agency: survey of opinions, knowledge and behaviours. Ann Ig 2013; 25 397–409.
| 1:STN:280:DC%2BC3sbpt1OjsA%3D%3D&md5=b32e2d3aa08619a0b6f3bf0edc799666CAS | 24048178PubMed |
[7] Middlestadt SE, Macy JT, Seo DC, Jay SJ, Kolbe LJ. The combined effect of behavioral intention and exposure to a smoke-free air law on taking measures to quit smoking. Health Promot Pract 2012; 13 553–8.
| The combined effect of behavioral intention and exposure to a smoke-free air law on taking measures to quit smoking.Crossref | GoogleScholarGoogle Scholar | 21422256PubMed |
[8] Mons U, Nagelhout GE, Allwright S, Guignard R, van den Putte B, Willemsen MC, Fong GT, Brenner H, Potschke-Langer M, Breitling LP. Impact of national smoke-free legislation on home smoking bans: findings from the International Tobacco Control Policy Evaluation Project Europe Surveys. Tob Control 2013; 22 e2–9.
| Impact of national smoke-free legislation on home smoking bans: findings from the International Tobacco Control Policy Evaluation Project Europe Surveys.Crossref | GoogleScholarGoogle Scholar | 22331456PubMed |
[9] Bauer JE, Hyland A, Li Q, Steger C, Cummings KM. A longitudinal assessment of the impact of smoke-free worksite policies on tobacco use. Am J Public Health 2005; 95 1024–9.
| A longitudinal assessment of the impact of smoke-free worksite policies on tobacco use.Crossref | GoogleScholarGoogle Scholar | 15914828PubMed |
[10] Kim B. Workplace smoking ban policy and smoking behavior. J Prev Med Pub Health 2009; 42 293–7.
| Workplace smoking ban policy and smoking behavior.Crossref | GoogleScholarGoogle Scholar |
[11] Ham DC, Przybeck T, Strickland JR, Luke DA, Bierut LJ, Evanoff BA. Occupation and workplace policies predict smoking behaviors: analysis of national data from the current population survey. J Occup Environ Med 2011; 53 1337–45.
| Occupation and workplace policies predict smoking behaviors: analysis of national data from the current population survey.Crossref | GoogleScholarGoogle Scholar | 21988795PubMed |
[12] Rose A, Fagan P, Lawrence D, Hart A, Shavers VL, Gibson JT. The role of worksite and home smoking bans in smoking cessation among U.S. employed adult female smokers. Am J Health Promot 2011; 26 26–36.
| The role of worksite and home smoking bans in smoking cessation among U.S. employed adult female smokers.Crossref | GoogleScholarGoogle Scholar | 21879940PubMed |
[13] Ruge J, Broda A, Ulbricht S, Klein G, Rumpf H-J, John U, Meyer C. Workplace smoking restrictions: smoking behavior and the intention to change among continuing smokers. Int J Public Health 2010; 55 599–608.
| Workplace smoking restrictions: smoking behavior and the intention to change among continuing smokers.Crossref | GoogleScholarGoogle Scholar | 20033252PubMed |
[14] Hyland A, Higbee C, Borland R, Travers M, Hastings G, Fong GT, Cummings KM. Attitudes and beliefs about secondhand smoke and smoke-free policies in four countries: findings from the International Tobacco Control Four Country Survey. Nicotine Tob Res 2009; 11 642–9.
| Attitudes and beliefs about secondhand smoke and smoke-free policies in four countries: findings from the International Tobacco Control Four Country Survey.Crossref | GoogleScholarGoogle Scholar | 19454550PubMed |
[15] Donchin M, Baras MA. ‘Smoke-free’ hospital in Israel: a possible mission. Prev Med 2004; 39 589–95.
| ‘Smoke-free’ hospital in Israel: a possible mission.Crossref | GoogleScholarGoogle Scholar | 15313099PubMed |
[16] Sarna L, Bialous SA, Wewers ME, Froelicher ES, Danao L. Nurses, smoking, and the workplace. Res Nurs Health 2005; 28 79–90.
| Nurses, smoking, and the workplace.Crossref | GoogleScholarGoogle Scholar | 15625705PubMed |
[17] Government of Western Australia. Celebrate smoke-free environments: the results of the post-smoke-free policy survey with Freemantle Hospital Health Service and Peel and Rockingham Kwinana staff. Perth: Government of Western Australia; 2008.
[18] Australian Institute of Health and Welfare (AIHW). Tobacco smoking status. METeOR Metadata Online Registry. Available at: http://meteor.aihw.gov.au [verified 1 March 2009].
[19] Wakefield MA, Spittal MJ, Yong HH, Durkin SJ, Borland R. Effects of mass media campaign exposure intensity and durability on quit attempts in a population-based cohort study. Health Educ Res 2011; 26 988–97.
| Effects of mass media campaign exposure intensity and durability on quit attempts in a population-based cohort study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3MbpslGgtg%3D%3D&md5=ef9c9360d8a5a710763e6febab73714dCAS | 21730252PubMed |
[20] Yong H-H, Borland R, Hammond D, Thrasher JF, Cummings KM, Fong GT. Smokers’ reactions to the new larger health warning labels on plain cigarette packs in Australia: findings from the ITC Australia project. Tob Control 2016; 25 181–7.
| Smokers’ reactions to the new larger health warning labels on plain cigarette packs in Australia: findings from the ITC Australia project.Crossref | GoogleScholarGoogle Scholar | 25700365PubMed |
[21] Berkelmans A, Burton D, Page K, Worrall-Carter L. Registered nurses’ smoking behaviours and their attitudes to personal cessation. J Adv Nurs 2011; 67 1580–90.
| Registered nurses’ smoking behaviours and their attitudes to personal cessation.Crossref | GoogleScholarGoogle Scholar | 21366668PubMed |
