[Smoke-free health institutions. Experiences from a central hospital]

Sentralsykehuset i Akershus is a county hospital serving a population of approximately 400,000 citizens. In 1984 a survey on smoking among the employees disclosed that 72% wanted a smoke-free working environment. According to an accepted three-year strategy the goal was a totally smoke-free hospital in 1990. This goal was not accomplished, and in 1990 a new survey (83% responders) indicated that among the 27% daily smokers only 49% were loyal to the non-smoking regulations. 76% however, wanted a smoke-free working environment. A large majority found it unrealistic to achieve a totally smoke-free hospital, and 70% wanted smoking areas for patients as well as for employees. The lack of success in achieving a totally smoke-free hospital has been analyzed. Important measures include better motivation, a well planned motivation process and various smoking cessation activities. Even more important are attitudes among leaders at different levels. They should identify with the goal "smoke-free hospital" on behalf of the hospital administration.