Smoking bans in US hospitals. Results of a national survey
D. R. Longo, R. C. Brownson and R. L. Kruse
Department of Family and Community Medicine, University of Missouri-Columbia School of Medicine, USA.
OBJECTIVE--To examine compliance and characteristics of hospitals with
tobacco control standards enacted by the Joint Commission of Accreditation
of Healthcare Organizations (JCAHO). DESIGN AND SETTING--On-site national
survey of hospitals as part of routine JCAHO accreditation visits.
PARTICIPANTS--A total of 3327 US hospitals received site visits in 1992 and
1993 and were matched with American Hospital Association Annual Survey of
Hospitals data. MAIN OUTCOME MEASURES--Compliance or noncompliance with
tobacco control standards; location in a tobacco-producing state; and
organizational characteristics, including provision of
psychiatric/alcohol-chemical dependency services. RESULTS--Two years after
implementation, 95.6% of hospitals met the new JCAHO smoking ban standard;
90.9% of hospitals were in compliance with a second smoking standard
requiring development and use of medical criteria for physician-ordered
exceptions to the ban. Hospitals in tobacco-producing states had
higher-than-average rates of compliance when compared with hospitals in
other states. Hospitals providing psychiatric and/or substance abuse
services had lower-than-average rates of compliance. CONCLUSION--This first
industry-wide smoking ban has been successful. However, hospitals should
consider evaluating the use of medical exceptions to this policy.
