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Smoking bans in US hospitals. Results of a national survey
D R Longo1, R C Brownson, R L Kruse
1Department of Family and Community Medicine, University of Missouri-Columbia School of Medicine, USA.
Objective:
To examine compliance and characteristics of hospitals with tobacco control standards enacted by the Joint Commission of Accreditation of Healthcare Organizations (JCAHO).
Design And Setting:
On-site national survey of hospitals as part of routine JCAHO accreditation visits.
Participants:
A total of 3327 US hospitals received site visits in 1992 and 1993 and were matched with American Hospital Association Annual Survey of Hospitals data.
Main Outcome Measures:
Compliance or noncompliance with tobacco control standards; location in a tobacco-producing state; and organizational characteristics, including provision of psychiatric/alcohol-chemical dependency services.
Results:
Two years after implementation, 95.6% of hospitals met the new JCAHO smoking ban standard; 90.9% of hospitals were in compliance with a second smoking standard requiring development and use of medical criteria for physician-ordered exceptions to the ban. Hospitals in tobacco-producing states had higher-than-average rates of compliance when compared with hospitals in other states. Hospitals providing psychiatric and/or substance abuse services had lower-than-average rates of compliance.
Conclusion:
This first industry-wide smoking ban has been successful. However, hospitals should consider evaluating the use of medical exceptions to this policy.