Effect of a Hospital Nonsmoking Policy on Patients' Knowledge, Attitudes, and Smoking Behavior

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Abstract
Purpose: To explore patients' knowledge of and attitudes toward a hospital nonsmoking policy and to examine changes in patients' smoking behavior before admission and after discharge. Design: Patients were surveyed by mail 1 week after hospitalization. Setting: A 379-bed Boston tertiary teaching hospital. Subjects: Seven hundred twenty-six patients were surveyed. There were 337 respondents, yielding a response rate of 59%. Outcome Measures: Policy knowledge, policy satisfaction, and smoking cessation assistance. Smoking status was assessed retrospectively by self-report 1 week before admission and at the time of the survey. Results: Bivariate and multiple logistic regression techniques were used to explore relationships among explanatory variables and outcomes. Knowledge of the policy was fair, although satisfaction with the policy was high. Twenty percent of patients reported that they had quit smoking at the time of the survey; 53% of quitters said they quit because of the policy. Thirty-nine percent of patients reported receiving assistance from medical providers, and 88 % were satisfied with this help. Smoking cessation assistance was not associated with quitting but was related to smoking less (p < 0.02). Conclusions: A hospital nonsmoking policy was well accepted by patients and may have had a favorable impact on patients' smoking behavior. Because intervention by health care providers was limited but appeared to be effective, smoking cessation assistance programs need to be developed and implemented in other hospitals so that these results can be generalizable.