The University Record, February 8, 1999

Hospitals, Medical School, Nursing go totally smoke-free on Valentine’s Day

Editor’s Note: This article is excerpted from one by Mary Jean Babic that appeared in the November/December 1998 Hospitals Star.

Paper hearts won’t be the only ones given consideration this Valentine’s Day. On Feb. 14, the U-M Hospitals and Health Centers, the Medical School and the School of Nursing will become completely smoke-free environments.

The move actually started in August 1997 with the creation of a Smoke-Free Environment Task Force. The multidisciplinary group was charged with establishing a smoke-free environment—including the property outside the facilities—that would correspond with the prohibitions on smoking indoors.

“Moving to a smoke-free environment is understood to be a tall challenge and leadership issue,” says Tony Denton, associate director for operations, who has been involved in the initiative from the start. However, he adds, UMHS and the School of Nursing are committed to the practice of healthy behaviors by staff, faculty, students, patients and visitors.

Reduction of the number of outdoor smoking areas has taken place since last summer, ultimately resulting in all properties owned and leased by the Health System and School of Nursing becoming smoke-free.

Denton says there has been an ongoing effort to balance the needs of smokers and nonsmokers, but even with areas that had been designated for smoking, compliance has been difficult. Health System leaders have received numerous complaints about the smoking in these areas and its effects on the health of others and the appearance of the environment.

To help prepare smokers for the reality of no longer being able to light up at work, psychologist Linda Thomas was appointed July 1 to coordinate smoking-cessation programs for the Tobacco Consultation Service. Since her arrival, more than 50 individuals have sought help to quit smoking.

Thomas, who chairs the Clinical Issues Task Force, focusing on the support aspects of individuals facing a smoking ban, has conducted five seven-week sessions, the first of which started in early September. Of the 13 people in that first session, eight quit smoking.

“It’s going to be very difficult at first,” says Thomas of the upcoming transition. “This is to be expected when managing a significant change in an institution’s culture. There’s no requirement for anyone to stop smoking. We’re not telling people they can’t smoke,” she adds. “We’re telling them they can’t smoke in our environment.”

Some committee members and employees have expressed concern that their smoking co-workers—and family members of patients—might function poorly without what may be their usual method of relieving stress.

While recognizing the addictive nature of smoking, the task force worked to endorse a policy that avoided any tacit approval of or indifference to smoking, because any concession would be inconsistent with the Health System’s desire to encourage healthy behavior.

“Clearly, there are going to be smokers out there who think they’re being targeted,” Thomas says. “But that’s not the point. Our program is aimed at smoking, and preventing harm to health, not to make smokers quit unless they wish to— and request our help.”

People who are unable to avoid smoking will be asked to leave the affected property, but they also will be offered cessation program material.

So what are the penalties for people who light up where they’re not supposed to? That policy is still being developed, but Thomas said that penalties for violation by employees would resemble those at any other institution and would reflect the progressive disciplinary philosophy of the University. Patients and visitors will be asked to extinguish cigarettes, but it is not yet clear what else can be done if they simply refuse.

The task force studied how the transition to a smoke-free environment was handled at other health care institutions, such as the Mayo Health System, where it took about a year for compliance to take full effect. Those involved in the effort at Mayo reported that when employees set an example of not smoking, patients and visitors follow suit.

“There’s a saying that ‘We cannot discover new oceans unless we have the courage to lose sight of the shore,’” Denton says. “That applies to going smoke-free. There are challenges, because smoking is a recognized addiction, but we are working actively to make a difference by helping people quit smoking and improve their health. This is a worthwhile voyage.”