[Non-smoking policy in the hospital: insight into policy-relevant social research]

This article reports on long-term activities of the social research group SALSS which have been supported by the Federal German Health Education Authority. Work started in 1989/90 with a representative survey among hospital managers in West Germany which--soon after reunification--was completed by similar action in East Germany. In both cases, the subjects were regulations and actual situation of non-smokers' protection in hospitals as well as plans for improvement. Based on the data gathered, handy information material and campaign aids were developed for "frontline" activists. Professional support has been given to persons engaged in devising and implementing measures to improve the situation. This includes assisting concerned hospitals in patient and staff surveys (design and data processing) which are meant to detect the weak spots of non-smokers' protection as well as the demands for changes. This contribution contains the findings of patient and staff surveys conducted in four establishments which may be regarded as typical of German hospitals. There is clear evidence that the rate of smokers is higher among staff members than among patients, and that conflicts about smoking are most likely to occur within the group of hospital employees. Especially non-smoking staff members demand that the hospital management shows more commitment to smoking restrictions. The findings support the notion that only a broad, careful step-by-step approach has reasonable chances to reduce smoking and improve non-smokers' protection in hospitals by combining structural measures (better separating smokers from non-smokers) with optimized regulations and health education.