Establishing smoke-free hospitals in Vietnam: A pilot project

Abstract

In Vietnam, a pilot 'smoke-free hospital' model was implemented in nine hospitals in 2009-2010 to supply lessons learned that would facilitate a replication of this model elsewhere. This study aimed to assess smoking patterns among health professionals and to detect levels of second-hand smoke (SHS) exposure within hospital premises before and after the 'smoke-free hospital' model implementation. A pre- and post-intervention cross-sectional study was conducted in nine purposively selected hospitals. Air nicotine levels were measured using passive nicotine monitors; smoking evidence was collected through on-site observations; and smoking patterns were assessed through interviews with health workers. Despite the 'smoke-free hospital' intervention, smoking continued among health-care workers who were former smokers. Specifically, self-reported smoking prevalence significantly decreased post-intervention, but the number of daily cigarettes smoked at workplaces among male health workers remained unchanged. Post-intervention, smoking was more likely to take place outside buildings and cafeterias. However, air nicotine levels in the doctors' lounges and in emergency departments did not change post-intervention. Air nicotine levels at other sites decreased minimally. Tailored tobacco cessation programmes, targeting current smokers and mechanisms to enforce non-smoking, should be established to meet requirements of Vietnam's comprehensive National Tobacco Control Law effective in May 2013.

Attitudes Toward Nonsmoking Policies and Tobacco Tax Increases

“…8 This means that implementing a smoke-free environment at workplaces in Vietnam may be feasible. However, the current study indicates that adults are less likely to agree with "no smoking in public places" than at workplaces.…”

“…10 In 2010, a study was conducted on secondhand smoke in Vietnam in different public places and found that the level of nicotine was much higher than the WHO standard, 11 whereas concentrated nicotine levels measured in hospitals was not. 8 It may not be easy in Vietnam to implement Decision No. 1315 in public places, unless Vietnam establishes a tobacco law with serious penalties for smoking in public places.…”

“…Smoking prevalence among health professionals decreased from 35.2% in 2009 to 20.1% in 2010; the average number of cigarettes smoked per day decreased from 7 to 5.2, and median nicotine concentration measured inside hospital wards decreased from 0.04 to 0.02 µg/m 3 . 8 This means that implementing a smoke-free environment at workplaces in Vietnam may be feasible.…”

Smoking cessation interventions on health-care workers: a systematic review and meta-analysis

“…Results for before-after studies were varying (P for homogeneity <0.01) and depended on the type of intervention: they were positive except for one of them, which showed tiny post intervention differences (Table 1). At risk of bias analysis, three studies reached a good score: Battle et al (1991) Dao Thi Minh et al (2015) performed a pre-and post-intervention cross-sectional study in nine selected hospitals after a ''smoke-free hospital model'' implementation: smoking prevalence significantly decreased post-intervention, but the number of daily cigarettes smoked at workplaces among male health workers remained unchanged. Moreover, air nicotine levels in the doctors' lounges and in emergency departments did not change post-intervention, while at other sites the levels decreased minimally.…”

Health system research in Vietnam: Generating policy-relevant knowledge

“…An, Kibria, Huy, Hai, and Stillman (2014) conducted a study to assess the effectiveness of a ‘smoke-free hospital’ model and found that, after the intervention, smoking was more likely to take place outside of buildings and cafeterias. However, air nicotine levels in the doctors’ lounges and in emergency departments did not change post-intervention.…”