Creating a Smoke-Free Hospital: Attitudes and Smoking Behaviors of Nurses and Physicians

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Abstract
Purpose.: To assess smoking prevalence and attitudes of physicians and nurses before a smoking ban. The relationship between pre-ban attitudes and post-ban smoking behavior was also studied. Design.: This is a prospective descriptive study of a cohort of nurses and physicians who were surveyed six months before and six months after a ban on smoking was implemented. Setting.: A large, 1,000-bed teaching hospital in the Northeast of the United States. Subjects.: All full-time members of the medical (n=1,496) and nursing staff (n=1,500) were surveyed. The overall response rate for the cohort was 41 % for physicians and 39% for nurses. Measures.: Surveys included standardized questions on current smoking behavior, and sociodemographic variables. Attitudes toward quitting and the smoking policy and attitudes about implementation and enforcement of the smoking ban were included. Results.: Both physicians and nurses were supportive of a smoke-free policy, but the two groups differed significantly on attitudes related to implementation and enforcement, with nurses being more accommodating toward smoking and less likely to enforce a ban on smoking. Physicians were more likely than nurses to quit smoking after implementation of the ban. Pre-ban attitudes were not predictive of post-ban changes in smoking behavior. Conclusions.: Physicians and nurses agreed with establishing a smoke-free environment but disagreed over the efforts needed to maintain the smoke-free environment. Quitting behavior was not influenced by pre-ban attitudes.

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