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Int. J. Environ. Res. Public Health 2017, 14(11), 1358; doi:10.3390/ijerph14111358

Hospital Smoke-Free Policy: Compliance, Enforcement, and Practices. A Staff Survey in Two Large Public Hospitals in Australia

1
School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308, Australia
2
Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales 2305, Australia
3
Department of General Medicine, John Hunter Hospital, New Lambton Heights, New South Wales 2305, Australia
4
Department of Traumatology, John Hunter Hospital, New Lambton Heights, New South Wales 2305, Australia
5
Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, New South Wales 2170, Australia
6
South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, New South Wales 2170, Australia
7
School of Human, Health and Social Sciences, Central Queensland University, Brisbane, Queensland 4000, Australia
8
Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria 3052, Australia
9
Hunter New England Population Health, Wallsend, New South Wales 2287, Australia
*
Author to whom correspondence should be addressed.
Received: 27 September 2017 / Revised: 5 November 2017 / Accepted: 6 November 2017 / Published: 8 November 2017
(This article belongs to the Special Issue Reducing Exposure to Second-Hand Tobacco Smoke)
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Abstract

Background: Smoke-free hospital policies are becoming increasingly common to promote good health and quit attempts among patients who smoke. This study aims to assess: staff perceived enforcement and compliance with smoke-free policy; the current provision of smoking cessation care; and the characteristics of staff most likely to report provision of care to patients. Methods: An online cross-sectional survey of medical, nursing, and allied staff from two Australian public hospitals was conducted. Staff report of: patient and staff compliance with smoke-free policy; perceived policy enforcement; the provision of the 5As for smoking cessation (Ask, Assess, Advise, Assist, and Arrange follow-up); and the provision of stop-smoking medication are described. Logistic regressions were used to determine respondent characteristics related to the provision of the 5As and stop-smoking medication use during hospital admission. Results: A total of 805 respondents participated. Self-reported enforcement of smoke-free policy was low (60.9%), together with compliance for both patients (12.9%) and staff (23.6%). The provision of smoking cessation care was variable, with the delivery of the 5As ranging from 74.7% (ask) to 18.1% (arrange follow-up). Medical staff (odds ratio (OR) = 2.09, CI = 1.13, 3.85, p = 0.018) and full time employees (OR = 2.03, CI = 1.06, 3.89, p = 0.033) were more likely to provide smoking cessation care always/most of the time. Stop-smoking medication provision decreased with increasing age of staff (OR = 0.98, CI = 0.96, 0.99, p = 0.008). Conclusions: Smoke-free policy enforcement and compliance and the provision of smoking cessation care remains low in hospitals. Efforts to improve smoking cessation delivery by clinical staff are warranted. View Full-Text
Keywords: smoking cessation care; tobacco control; smoke-free policy smoking cessation care; tobacco control; smoke-free policy
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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McCrabb, S.; Baker, A.L.; Attia, J.; Balogh, Z.J.; Lott, N.; Palazzi, K.; Naylor, J.; Harris, I.A.; Doran, C.M.; George, J.; Wolfenden, L.; Skelton, E.; Bonevski, B. Hospital Smoke-Free Policy: Compliance, Enforcement, and Practices. A Staff Survey in Two Large Public Hospitals in Australia. Int. J. Environ. Res. Public Health 2017, 14, 1358.

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