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Reuters
The number of smokers lighting up on hospital grounds has fallen about seven percentage points since 1995, according to a new study.
"It is encouraging that there has been improvement, but it's discouraging that the nicotine replacement therapy has not been able to put more of a dent into this," said the study's lead author Susan Regan, an instructor of medicine at Harvard Medical School in Boston.
The findings reflect the experience of Boston's Massachusetts General Hospital, where past research found that 25 percent of hospitalized smokers reported smoking on the grounds in 1995.
In the new study, which surveyed patients who smoked and were referred to the hospital's tobacco treatment program between 2007 to 2010, the researchers found that the number of smokers lighting up on hospital grounds during their entire stay fell to 18.4 percent.
One explanation for the decline, according to the researchers, is the increased use of nicotine replacement therapy patches, lozenges, gum and inhalers.
They write in the Archives of Internal Medicine that the use of nicotine replacement therapy at the hospital increased more than twelve-fold from 1995 to 2010.
However, they cannot say for certain that the therapy is the reason for the decline.
For example, the new study only included patients in the hospital's tobacco treatment program while the previous study included all patients who smoked. The researchers write that those who refused to take part in the program may have been more likely to sneak a smoke.
Regan told Reuters Health that an overall decline of smoking shouldn't directly influence their findings, because they only looked at the percentage of smokers who lit up.
As for smokers who still smoke while hospitalized, Regan told Reuters Health that some may just not be ready to quit.
"Many smokers are interested in quitting. Some are interested but not ready, and some are just not interested," she said.
In the new study, which followed about 5,400 smokers, the researchers found that certain characteristics were linked to a person being more likely to abstain from smoking, including being over 50 and having heart problems.
Smoke-free campus
The Joint Commission, a nonprofit group that accredits more than 19,000 hospitals and other healthcare facilities, already prohibits U.S. hospitals from allowing smoking in their buildings.
Patients and staff, however, may smoke outside the building, unless the hospital bans that too.
In Massachusetts General's case, the hospital allows people to smoke at two smoking shelters on its property, which is where Regan said smokers most likely lit up.
"I think that if you really want to completely eliminate smoking, you have to make the (hospital) campus smoke free, but you're also going to have to prevent patients from leaving the floor to smoke," said Regan.
But, she added that brings up other questions, including how to not burden already busy nurses.
"There is no easy solution to this, but clearly making the campus smoke free is a step in the right direction," she said.
Dr. Steven Schroeder, who wrote an editorial accompanying the new study, agreed that smoke-free campuses are a good idea.
"There are many hospitals now that are making themselves totally smoke free. You may say that's not fair to the patient, but we can offer them nicotine replacement therapy," said Schroeder, of the University of California, San Francisco.
Regan warns, however, that these results are only based on one hospital, and the conditions it faces may not be the same as others.
"If you did it in a warm weather state, you might find more patients who are more likely to go out and smoke. But we don't know," said Regan.
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I would say it is a lot higher than that because that is just the ones who tell about it. Most won't. Also, a hospital is not a jail, and I don't know what gives them the idea that they have the right to tell someone they can't leave. The only difference they are surveying here is if they crossed a line in the sidewalk that marks the hospital campus.
I thought the same thing when I read the article. No one can tell me that I cannot leave my hospital room to smoke, just as no one can tell me that I cannot leave my hospital room to visit the cafeteria or the gift shop.
A private business does have the right to decide here on it's own property as long as it's not big government tellling people what to do. The number is probably higher than reported since tobacco is so demonized. Electronic cigarettes are another option now, so see E Cig Werks blog for more.
Hospital went smoke free years ago. Nobody smokes on campus, not anyone. Not the doctor, not the nurse, not the visitor, not the patient. Free smoking cessation treatment is available and nicotine replacement therapy is given to all patients who need it. I do not have the time and effort to waste taking my patient outside to smoke. In Baltimore when I was in nursing school the patients were leaving the hospital with IV lines intact and going to the heroin market outside to shoot up. The nurses threatened to strike over this. We were being held responsible for the outcome when patients smoked crack, put dirty needles into their IVS, etc. But we had no power to stop the patients. Now if you are healthy enough to leave the building on your own power, you get all your lines taken out or you are discharged. I don't have to help you poison yourself.
On my last day of nursing school I walked into my patients room and saw him smoking in bed. With a high flow oxygen device on his face. Hooked up to the hospital oxygen system. Nobody wanted to offend him by taking away the cigs. I marched in there and told him OH HELL NO you arent going to get us all blown up and burn your face off on my watch! I took away the cigs and the guy got the point.
I'm pretty sure the only ones who can discharge patients is doctors...not nurses.
And patients need to be prevented from going outside to shoot up. Heroin is illegal. Cigarettes, however, are not. And you cannot prevent me from enjoying a perfectly legal product.
dom, and who is going to determine who the illegal user is? Read amazonmom's post and the liability of nurses. So you go outside and smoke a legal cigarette and die who do you think your survivor's will sue? amazonmom: great hospital policy concerning persons who wander off their unit for any reason and I assume that is for liability concerns.
So Harvard's Susan Regan says, ""There is no easy solution to this,"
Really? No easy solution? How about making it illegal to blackmail hospitals into forcing patients and staff to smoke outside? There is no sound reason for forbidding hospitals to provide separately ventilated indoor smoking areas for their smokers, but this "Joint Commission" which holds the all powerful strings of hospital accreditation is blackmailing them with the threat of removing that accreditation unless they conform. This is the same game the Antismokers are now playing with Universities and outdoor campus bans: if they don't knuckle under to the blackmail their grant funding will be grabbed and the Universities will effectively have to close.
There are NO studies showing any degree of harm to people outside of decently designed, separately ventilated smoking lounge areas. The ONLY reason for forbidding such things at colleges and hospitals is behavior control conditioning: the same sort of thing experimenters do to teach rats the "desired" behavior with electric shocks.
People, even smokers, are not rats ... not even when they're helpless and in the hospital.
Michael J. McFadden
Author of "Dissecting Antismokers' Brains"