News Release

Should all hospitals be smoke free?

Editorial: smoke free hospitals BMJ Volume 326, pp 941-2

Peer-Reviewed Publication

BMJ

The recent decision by the Royal Victoria Hospital in Belfast to build seven smoking rooms for patients and staff at a cost of £500,000 provoked condemnation from many sources. In this week's BMJ researchers argue that these resources might have been better used to implement a smoking ban and expand smoking cessation activities.

The value of hospitals making a clear statement on public smoking can be seen from a recent study showing that total workplace bans would have an effect equivalent to an almost doubling of the price of cigarettes in the United Kingdom. Other considerations include protection of other patients and staff from exposure to second hand smoke, and a reduction in the risk of fires and in cleaning costs.

Some will argue that bans on smoking in hospitals will not work because of opposition by staff or patients, yet studies confirm that smoking bans can work in NHS hospitals if designed and implemented appropriately.

But should hospitals go further and actively help patients to quit smoking either before coming into hospital or during and after their stay?

The potential benefits are considerable, say the authors. One trial found that 90% of patients who received counselling and nicotine replacement six to eight weeks before surgery either ceased or reduced smoking, were less likely to experience postoperative complications, and to need secondary surgery.

Another review found that behavioural interventions with patients admitted to hospital were associated with higher quit rates for at least a month afterwards.

Given this evidence, it is arguable that resources expended on smoking rooms might be better used to fund a concerted effort to implement a smoking ban and to expand smoking cessation activities, say the authors. Hopefully other hospitals facing a similar situation will act differently in the future.

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