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Open AccessArticle

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

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School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308, Australia
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Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales 2305, Australia
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Department of General Medicine, John Hunter Hospital, New Lambton Heights, New South Wales 2305, Australia
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Department of Traumatology, John Hunter Hospital, New Lambton Heights, New South Wales 2305, Australia
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Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, New South Wales 2170, Australia
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South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, New South Wales 2170, Australia
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School of Human, Health and Social Sciences, Central Queensland University, Brisbane, Queensland 4000, Australia
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Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria 3052, Australia
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Hunter New England Population Health, Wallsend, New South Wales 2287, Australia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2017, 14(11), 1358; https://doi.org/10.3390/ijerph14111358
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)
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
MDPI and ACS Style

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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