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Smoke-free hospitals – the English experience: results from a survey, interviews, and site visits

BACKGROUND: According to the provisions of the Health Act 2006, NHS acute Trusts had to become smoke-free by July 2007. Mental health Trusts were granted a further year before all indoor smoking areas have to be removed. This study was carried out to determine the extent of smoke-free policy impleme...

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Autores principales: Ratschen, Elena, Britton, John, McNeill, Ann
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2266918/
https://www.ncbi.nlm.nih.gov/pubmed/18282278
http://dx.doi.org/10.1186/1472-6963-8-41
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author Ratschen, Elena
Britton, John
McNeill, Ann
author_facet Ratschen, Elena
Britton, John
McNeill, Ann
author_sort Ratschen, Elena
collection PubMed
description BACKGROUND: According to the provisions of the Health Act 2006, NHS acute Trusts had to become smoke-free by July 2007. Mental health Trusts were granted a further year before all indoor smoking areas have to be removed. This study was carried out to determine the extent of smoke-free policy implementation in English NHS acute and mental health Trusts, and to explore challenges and impacts related to policy implementation. METHODS: Questionnaire-based survey of all English NHS acute and mental health hospital settings, supplemented by semi-structured telephone interviews with 22 respondents and direct observation at a sample of 15 Trusts (22 different sites). Human Resources Directors of all 245 English NHS Trusts providing acute and/or mental health inpatient care were identified as potential study participants. Main outcome measures comprised the proportions of Trusts reporting smoke-free policy implementation; whether these relate to buildings only or to whole premises including grounds; most frequently reported exemptions; reported and observed frequencies of policy breaches. RESULTS: Smoke-free policies were reported to be implemented in all mental health and 98% of acute settings studied. They applied to whole premises including grounds in 84% of acute, and 64% of mental health settings. However, exemptions were granted by 50% of acute and 78% of mental health settings, typically for bereaved relatives or psychiatric patients, in sheltered outdoor areas and smoking rooms. Reported challenges included policy enforcement and related risks of abuse, and litter on premises and adjacent public grounds. Nearly two thirds of acute and over a third of mental health trusts reported that policy infringements occurred on a daily basis. Indeed, patients and visitors were observed smoking at 94% of acute sites visited and staff smoking at 35% of them. CONCLUSION: NHS hospitals should play an exemplary role in making a smoke-free environment the norm. Although smoke-free policies have been implemented in nearly all English NHS hospitals, exemptions are frequently granted and policy breaches appear to be commonplace.
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spelling pubmed-22669182008-03-12 Smoke-free hospitals – the English experience: results from a survey, interviews, and site visits Ratschen, Elena Britton, John McNeill, Ann BMC Health Serv Res Research Article BACKGROUND: According to the provisions of the Health Act 2006, NHS acute Trusts had to become smoke-free by July 2007. Mental health Trusts were granted a further year before all indoor smoking areas have to be removed. This study was carried out to determine the extent of smoke-free policy implementation in English NHS acute and mental health Trusts, and to explore challenges and impacts related to policy implementation. METHODS: Questionnaire-based survey of all English NHS acute and mental health hospital settings, supplemented by semi-structured telephone interviews with 22 respondents and direct observation at a sample of 15 Trusts (22 different sites). Human Resources Directors of all 245 English NHS Trusts providing acute and/or mental health inpatient care were identified as potential study participants. Main outcome measures comprised the proportions of Trusts reporting smoke-free policy implementation; whether these relate to buildings only or to whole premises including grounds; most frequently reported exemptions; reported and observed frequencies of policy breaches. RESULTS: Smoke-free policies were reported to be implemented in all mental health and 98% of acute settings studied. They applied to whole premises including grounds in 84% of acute, and 64% of mental health settings. However, exemptions were granted by 50% of acute and 78% of mental health settings, typically for bereaved relatives or psychiatric patients, in sheltered outdoor areas and smoking rooms. Reported challenges included policy enforcement and related risks of abuse, and litter on premises and adjacent public grounds. Nearly two thirds of acute and over a third of mental health trusts reported that policy infringements occurred on a daily basis. Indeed, patients and visitors were observed smoking at 94% of acute sites visited and staff smoking at 35% of them. CONCLUSION: NHS hospitals should play an exemplary role in making a smoke-free environment the norm. Although smoke-free policies have been implemented in nearly all English NHS hospitals, exemptions are frequently granted and policy breaches appear to be commonplace. BioMed Central 2008-02-18 /pmc/articles/PMC2266918/ /pubmed/18282278 http://dx.doi.org/10.1186/1472-6963-8-41 Text en Copyright © 2008 Ratschen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ratschen, Elena
Britton, John
McNeill, Ann
Smoke-free hospitals – the English experience: results from a survey, interviews, and site visits
title Smoke-free hospitals – the English experience: results from a survey, interviews, and site visits
title_full Smoke-free hospitals – the English experience: results from a survey, interviews, and site visits
title_fullStr Smoke-free hospitals – the English experience: results from a survey, interviews, and site visits
title_full_unstemmed Smoke-free hospitals – the English experience: results from a survey, interviews, and site visits
title_short Smoke-free hospitals – the English experience: results from a survey, interviews, and site visits
title_sort smoke-free hospitals – the english experience: results from a survey, interviews, and site visits
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2266918/
https://www.ncbi.nlm.nih.gov/pubmed/18282278
http://dx.doi.org/10.1186/1472-6963-8-41
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