Making Canadian Healthcare Facilities 100% Smoke-Free: A National Trend Emerges

A qualitative investigation of smoke-free policies on hospital property

“…2,4,5 However, noncompliance and inadequate treatment for tobacco dependence appear to be the norm. 29 Enhancing appropriate health care for patients who use tobacco to include consistent and effective treatment for the symptoms of withdrawal may improve this problem.…”

“…1,2 In response, Canadian health authorities and hospitals began implementing policies mandating smoke-free hospital property, with the goals of reducing the exposure of workers, patients and visitors to tobacco smoke while delivering a public health message about the dangers of smoking. [2][3][4][5] An additional anticipated outcome was the reduced use of tobacco among patients and staff. The impetuses for adopting smokefree policies include public support for such legislation and the potential for litigation for exposure to second-hand smoke.…”

“…The impetuses for adopting smokefree policies include public support for such legislation and the potential for litigation for exposure to second-hand smoke. 2,4 Tobacco use is a modifiable risk factor associated with a variety of cancers, cardiovascular diseases and respiratory conditions. [6][7][8][9][10][11] Patients in hospital who use tobacco tend to have more surgical complications and exacerbations of acute and chronic health conditions than patients who do not use tobacco.…”

“…19 Assessments of the effectiveness of smoke-free policies for hospital property tend to focus on noncompliance and related issues of enforcement. 17,20,21 Although evidence of noncompliance and litter on hospital property 2,17,20 implies ongoing exposure to tobacco smoke, half of the participating hospital sites in one study reported less exposure to tobacco smoke within hospital buildings and on the property. 18 In addition, there is evidence to suggest some decline in smoking among staff.…”

A Capital Approach: Tobacco Treatment and Cessation within Nova Scotia's Capital Health District

“…APTS recognizes that, as general public tobacco use rates continue to decline across the country, the burden of disease, financial hardship and death caused by tobacco dependence falls to these "special populations." The chronically mentally ill, for example, have very high using rates, face unique barriers to cessation within some treatment facilities and are particular targets of the tobacco industry (see Parle et al 2005). One proposal to help reduce barriers between high-risk users and treatment is the concept of a "nicotine maintenance clinic" where those who are addicted to nicotine and are most vulnerable can have open access to clean, free nicotine (in the form of NRT) and receive counselling in a welcoming setting.…”