Compliance with the smoke-free policy in hospitals in Spain: the patients’ perspective

Abstract

Objective To explore compliance with the smoke-free policy in hospitals in Catalonia, Spain, by exploring inpatients’ perceptions. Methods We conducted a cross-sectional study of a random sample of 1047 inpatients from 13 public hospitals. We collected data about: (a) type of information about the smoke-free policy provided by the hospital, (b) patients’ knowledge about the policy, (c) general appreciation of the compliance with the policy, and (d) specific appreciation of such compliance by noticing any sign of tobacco consumption. We described the data by several patients’ and hospitals’ characteristics and assessed their association with the perceived noncompliance using prevalence ratios (PR) and their 95% confidence intervals (CIs). Results Few patients were informed about the smoke-free policy (4.8% orally, 6.1% in writing, and 55.6% through sign postings). About 64% were aware of the regulation and 73.5% believed that it was properly obeyed. While 0.7% had never or rarely observed smoking indoors, 36.2% had seen someone smoking outdoors sometimes or many times. Signs of tobacco consumption were observed indoors and outdoors. Factors associated with the perception of noncompliance were: being less than 45 years old versus being more than 64 years old (adjusted PR, 2.33; 95% CI, 1.09–4.98) and currently smoking versus have never smoked (adjusted PR, 1.84; 95% CI, 1.02–3.34). Conclusion Compliance with the smoke-free policy in hospitals according to the patients’ view is notable, although several infringements were reported, mainly outdoors. The smoke-free policy in hospitals should be reinforced by prompting continuous awareness campaigns and the exemplary role of hospital workers.

Chronic obstructive pulmonary disease mortality trends in Spain, 1980-2020

“…It is well established that smoking is the leading cause and most important risk factor for developing COPD in Spain. Although it would be reasonable to interpret the observed overall decline in COPD mortality as confirming that public health interventions on smoking [ 13 ] and medical treatment have improved outcomes [ 14 ], the possible causes for the observed disparities between genders and age groups are of concern, and further studies are needed. A possible factor to take into account relates to changes in the prevalence of COPD in Spain.…”

Evidence from a Smoking Management Service in a University Teaching Hospital in Dublin, Ireland monitored by repeat surveys, 1997–2022

“…Our experience with a smoke-free campus is not unique. Fu et al (2022) report that compliance with non-smoking outdoors on a hospital campus can be hard to achieve. Garritsen and colleagues in association with smoke-free policies also saw a decline in smoking prevalence ( Garritsen et al 2022 ).…”

Smoking behaviour, tobacco sales and tobacco advertising at 40 ‘Smoke Free Hospitals’ in Vietnam

“…19 Studies in other settings have also demonstrated limited compliance with smoke-free policies. 20 In Spain, 64% of patients were aware of a smoke-free hospitals policy. 21 The same showed a reduction in smoking prevalence following the implementation of smoke-free hospitals.…”