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Hospital smoking bans creating unintended safety issues for patients

Tue 1st November, 2011

New Canadian research has found that not only are patients and staff ignoring hospital smoking bans, but the policies are also creating safety issues for patients.

The study is based on the "lived experiences" of 186 patients, staff and "key informants" - including housekeepers, security guards and groundskeepers - at two hospitals: the University of Alberta Hospital in Edmonton and Winnipeg's Health Sciences Centre.

Data were collected over six months - December 2008 to May 2009 - that included a cold Canadian winter. Both sites had a policy banning smoking inside all buildings, entrances and all hospital grounds for three years before the study began.

Overall, the researchers found ample evidence that "non-compliance" seems to be the norm. People were seen smoking directly under or nearby signs explicitly stipulating a smoke-free zone.

Smokers, especially patients in wheelchairs or connected to equipment, were usually found near entrances or in places where they could hide while they smoked.

In interviews, patients said they didn't feel safe going outside alone to smoke. Some worried "about getting suddenly sick while smoking outside." Some risked frostbite.

Security guards described patients "pushing this IV pole all the way down the sidewalk in the snow" after being told not to smoke on hospital grounds. There were reports of IV lines freezing and having to be restarted, or electronic equipment malfunctioning.

The researchers described patients in isolation from infections such as tuberculosis wearing a mask outside while they smoked, but then tossing their butts on the ground, making the discarded butts potential "vectors" for infection if they're collected and smoked by someone else.

One patient was locked out of one of the hospitals at night because he didn't see the sign saying the doors lock after a certain hour. The sign was at eye level; he couldn't see it from his wheelchair.

Smoke-free policies are leading to other unintended consequences, including disruptions to nursing care when patients leave the ward for a smoke and nurses have no idea when they'll return.

Source: Montreal Gazette (1 November 2011)

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