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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Smoke-free hospital grounds

Victoria Malone https://orcid.org/0000-0003-3668-9754 A B , James McLennan A and David Hedger A
+ Author Affiliations
- Author Affiliations

A St Vincent’s Hospital Sydney, 390 Victoria Street, Darlinghurst, NSW 2010, Australia. Email: James.McLennan@svha.org.au; David.Hedger@svha.org.au

B Corresponding author. Email: Victoria.Malone@svha.org.au

Australian Health Review 44(3) 405-409 https://doi.org/10.1071/AH19125
Submitted: 3 June 2019  Accepted: 27 August 2019   Published: 20 January 2020

Abstract

This study investigated whether the implementation of a multicomponent intervention project could improve compliance with the New South Wales (NSW) Health smoke-free healthcare policy. Environmental interventions were implemented on the hospital grounds for a 12-week period. Compliance was measured by a pre- and postintervention observational count of smokers on the hospital grounds. After implementation, there was a significant 73% reduction in people smoking on the hospital grounds, indicating improved compliance with the NSW smoke-free healthcare policy through the use of a non-punitive multicomponent intervention.

What is known about the topic? Lack of compliance with the NSW Health smoke-free healthcare policy was reflected by the large numbers of smokers outside the front of an inner-city hospital in Sydney, Australia. This issue had been raised by staff, patients and visitors as an ongoing problem requiring a solution.

What does this paper add? Designing and implementing a non-punitive multicomponent intervention using modelling, operant and associative learning principles can successfully increase compliance with policies designed to stop smoking on hospital grounds.

What are the implications for practitioners? Implementing non-punitive multicomponent interventions to improve compliance with the NSW Health smoke-free healthcare policy may increase patients’ acceptance of smoking cessation support when offered. Healthcare staff need to be equipped with the knowledge and confidence to offer this support.

Additional keywords: environment, nicotine-replacement therapy, patients, smoking, visitors.


References

[1]  Nagle AL, Schofield MJ, Redman S. Smoking on hospital grounds and the impact of outdoor smoke-free zones. Tob Control 1996; 5 199–204.
Smoking on hospital grounds and the impact of outdoor smoke-free zones.Crossref | GoogleScholarGoogle Scholar | 9035354PubMed |

[2]  Wheeler JG, Pulley L, Felix HC, Bursac Z, Siddiqui NJ, Stewart MK, Mays GP, Gauss H. Impact of a smoke-free hospital campus policy on employee and consumer behavior. Public Health Rep 2007; 122 744–52.
Impact of a smoke-free hospital campus policy on employee and consumer behavior.Crossref | GoogleScholarGoogle Scholar | 18051667PubMed |

[3]  Shopik NA, Schultz AS, Nykiforuk CI, Finegan BA, Kvern MA. Impact of smoke-free hospital grounds policies: patient experiences and perceptions. Health Policy 2012; 108 93–9.
Impact of smoke-free hospital grounds policies: patient experiences and perceptions.Crossref | GoogleScholarGoogle Scholar | 22940063PubMed |

[4]  Rigotti NA, Arnsten JH, McKool KM, Wood-Reid KM, Pasternak RC, Singer DE. Smoking by patients in a smoke-free hospital: prevalence, predictors, and implications. Prev Med 2000; 31 159–66.
Smoking by patients in a smoke-free hospital: prevalence, predictors, and implications.Crossref | GoogleScholarGoogle Scholar | 10938217PubMed |

[5]  Schultz AS, Finegan B, Nykiforuk CI, Kvern MA. A qualitative investigation of smoke-free policies on hospital property. CMAJ 2011; 183 E1334–44.
A qualitative investigation of smoke-free policies on hospital property.Crossref | GoogleScholarGoogle Scholar | 22042991PubMed |

[6]  Sabidó M, Sunyer J, Masuet C, Masip J. Hospitalized smokers: compliance with a nonsmoking policy and its predictors. Prev Med 2006; 43 113–16.
Hospitalized smokers: compliance with a nonsmoking policy and its predictors.Crossref | GoogleScholarGoogle Scholar | 16630651PubMed |

[7]  Shipley M, Allcock R. Achieving a smoke-free hospital: reported enforcement of smoke-free regulations by NHS health care staff. J Public Health (Oxf) 2008; 30 2–7.
Achieving a smoke-free hospital: reported enforcement of smoke-free regulations by NHS health care staff.Crossref | GoogleScholarGoogle Scholar |

[8]  Office on Smoking and Health (US). The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention; 2006. Available at: https://www.ncbi.nlm.nih.gov/books/NBK44324/ [verified 10 September 2018].

[9]  International Agency for Research on Cancer (IARC). Evaluating the effectiveness of smoke-free policies. IARC handbooks of cancer prevention, Vol. 13. Lyon, France: IARC; 2009. Available at: https://publications.iarc.fr/Book-And-Report-Series/Iarc-Handbooks-Of-Cancer-Prevention/Evaluating-The-Effectiveness-Of-Smoke-free-Policies-2009 [verified 14 November 2019].

[10]  Edwards R, Thomson G, Wilson N, Waa A, Bullen C, O’Dea D, Gifford H, Glover M, Laugesen M, Woodward A. After the smoke has cleared: evaluation of the impact of a new national smoke-free law in New Zealand. Tob Control 2008; 17 e2
After the smoke has cleared: evaluation of the impact of a new national smoke-free law in New Zealand.Crossref | GoogleScholarGoogle Scholar | 18218788PubMed |

[11]  Ragg M, Ahmed T. Smoke and mirrors: a review of the literature on smoking and mental illness. Sydney: Cancer Council NSW; 2008.

[12]  Mons U, Nagelhout GE, Guignard R, McNeill A, Van den Putte B, Willemsen MC, Brenner H, Pötschke-Langer M, Breitling LP. Comprehensive smoke-free policies attract more support from smokers in Europe than partial policies. Eur J Public Health 2012; 22 10–16.
Comprehensive smoke-free policies attract more support from smokers in Europe than partial policies.Crossref | GoogleScholarGoogle Scholar | 22294779PubMed |

[13]  Bandura A, Walters RH. Social learning theory. Englewood Cliffs, NJ: General Learning Press; 1977.

[14]  Davies L, Batalden P, Davidoff F, Stevens D, Ogrinc G. The SQUIRE guidelines: an evaluation from the field, 5 years post release. BMJ Qual Saf 2015; 24 769–75.
The SQUIRE guidelines: an evaluation from the field, 5 years post release.Crossref | GoogleScholarGoogle Scholar | 26089206PubMed |

[15]  Bandura A. Modeling theory: some traditions, trends, and disputes. In: Parke RD, editor. Recent trends in social learning theory. Yellow Springs, OH: Academic Press; 1972. pp. 35–61.

[16]  Grusec JE. Social learning theory and developmental psychology: the legacies of Robert Sears and Albert Bandura. Dev Psychol 1992; 28 776–86.
Social learning theory and developmental psychology: the legacies of Robert Sears and Albert Bandura.Crossref | GoogleScholarGoogle Scholar |

[17]  Skinner BF. Science and human behaviour. New York, NY: Simon & Schuster; 1953.

[18]  Spence KW. Behavior theory and conditioning. New Haven, CT: Yale University Press; 1956.

[19]  Malone V, Ezard N, Hodge S, Ferguson L, Schembri A, Bonevski B. Nurse provision of support to help inpatients quit smoking. Health Promot J Austr 2017; 28 251–54.
Nurse provision of support to help inpatients quit smoking.Crossref | GoogleScholarGoogle Scholar | 28002718PubMed |

[20]  Derksen F, Bensing J, Lagro-Janssen A. Effectiveness of empathy in general practice: a systematic review. Br J Gen Pract 2013; 63 e76–84.
Effectiveness of empathy in general practice: a systematic review.Crossref | GoogleScholarGoogle Scholar | 23336477PubMed |

[21]  Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof 2004; 27 237–51.
The effects of physician empathy on patient satisfaction and compliance.Crossref | GoogleScholarGoogle Scholar | 15312283PubMed |