Staff and patient perspectives of a smoke-free health services policy in South Australia: A state-wide implementation

Health Policy. 2017 Aug;121(8):895-902. doi: 10.1016/j.healthpol.2017.06.003. Epub 2017 Jun 20.

Abstract

Few jurisdictions have implemented and evaluated a complete smoking ban across all health sites in their jurisdiction, with no designated smoking areas. This article examines staff and patient perceptions and experiences of a mandated smoke-free policy implemented across all government health facilities in South Australia, including mental health sites. An online survey of health staff was conducted prior to policy implementation (n=3098), 3 months post-implementation (n=2673) and 15 months post-implementation (n=2890). Consumer experiences of the policy were assessed via a telephone survey (n=1722; smokers n=254). Staff support for the policy was high across all time points. Two thirds of staff reported having witnessed some policy non-compliance, and self-reported exposure to second-hand smoke was comparable pre-implementation to 15 months post-implementation. Under the policy, 56.3% of smoking patients abstained completely whilst hospitalised and 37.6% cut down the amount that they smoked. Furthermore, 34.7% reported having been offered cessation support during hospitalisation. Whilst the smoke-free policy was viewed positively and had benefits for staff and patients, reports of witnessing some non-compliance were prevalent. While the extent of non-compliance is not known, and the measure used was sensitive, complementary strategies may be needed to reduce exposure to second-hand smoke, particularly at entrances. Health-care staff should be further encouraged to offer support to nicotine-dependent patients to foster compliance and promote abstinence during hospitalisation.

Keywords: Attitude of health personnel; Health services; Smoke-free policy; Tobacco dependence.

MeSH terms

  • Adolescent
  • Adult
  • Attitude of Health Personnel*
  • Female
  • Health Services Administration
  • Humans
  • Inpatients / psychology*
  • Male
  • Middle Aged
  • Occupational Exposure / statistics & numerical data
  • Organizational Policy
  • Smoke-Free Policy*
  • Smoking
  • Smoking Cessation / statistics & numerical data
  • South Australia
  • Surveys and Questionnaires
  • Tobacco Smoke Pollution / statistics & numerical data

Substances

  • Tobacco Smoke Pollution