A "smoke-free" hospital in Israel--a possible mission

A revised antismoking law in Israel (August 2001) called for a complete ban of smoking in hospitals. An evaluation of a hospital process and short-term outcome of implementing such policy may guideline its sustainability.

Two cross-sectional, random-sample surveys of employees 3 months before policy implementation, and 6-9 months post-implementation. The pre-implementation survey included 368 employees (90.4% response rate) and the post-implementation survey, 364 (92.8% response rate).

The 'smoke-free' policy significantly reduced smoking in the unauthorized areas. Before implementation, 63% of staff reported frequently observing smoking in the hospital, compared to 40% 6 months post-policy implementation (P < 0.001). Significantly more smokers reported leaving their workplace to smoke (17% pre- vs. 62% post-implementation, P < 0.0001). Sixty-five percent of smokers, in both surveys, agreed that "a smoke-free policy is unfair to smokers". Fewer nonsmokers subscribed to this belief: 42% pre- and 34% post-implementation. Smoker prevalence remained unchanged (19%).

Implementation of a "smoke-free" policy is an effective way to reduce smoking in the hospital environment. More effort is required, however, to help staff quit smoking altogether.