Hospitals attempt to block smoking on their premises

Facilities aim to stop patients and caregivers from lighting up

December 30, 2006|By E.A. Torriero | E.A. Torriero,Chicago Tribune

LOUISVILLE -- Samantha McCandless began smoking when she was 9 after her teenage baby sitter introduced her to cigarettes.

More than a quarter-century later, despite being a nursing supervisor at a busy trauma center, McCandless has no plans to stop her two-pack-a-day habit. Three to four times during a 12-hour shift, McCandless takes a break and smokes in the hospital's designated area.

She knows the health risks.

"But I like smoking," McCandless, 36, said during a break at Louisville's University Hospital emergency room. "I don't have a desire to quit."

McCandless' quest to smoke at work will likely get tougher in coming months.

Following national smoking-prohibition trends, more and more hospitals are banning smoking on their properties.

Across America - even here in the heart of tobacco country - health care establishments are fed up with people, including patients hooked to intravenous units and nurses who treat them, smoking on their premises.

As they consider bans, hospitals are becoming more aggressive in persuading their practitioners to stop smoking, not only because of concerns about their health but also because the use of tobacco by health professionals sends a hypocritical message to patients.

As a group, nurses are among America's top smokers: 16 percent of the nation's 2.3 million nurses smoke, compared with 2 percent to 3 percent of doctors, surveys show. Nurses in scrubs can be seen puffing outside the very wards where they dispense advice to patients ill from the effects of smoking.

"The nurses-smoking thing continues to astound me," said Connie L. Sorrell, director of the Kentucky Cancer Program. "But physicians and nurses are just people. This speaks to how strong the addiction is."

Yet, in the battle against smoking, health care facilities are a conflicted frontier. As cities and businesses across America go smoke-free, many hospitals have been reluctant to do the same.

Medical administrators fear that patients and families stressed by health problems could be pushed over the edge if prohibited from smoking in front of the hospital.

As for nurses and other caregivers who smoke, the thinking goes, lighting up provides a release from tension during long, difficult shifts. Also, researchers say that blanket bans are often not the solution to helping people kick bad habits.

"On the one hand, there is recognition that smokers are enslaved by an addiction," said Brad Rodu, director of the University of Louisville's tobacco-harm-reduction research project, which receives grants from tobacco companies. "On the other, society treats them like outcasts."

In a 12-block area of downtown Louisville that is home to dozens of medical facilities, the question of what to do about smoking is playing out in daily debate.

The answers are not easy in a state where thousands of people make a living growing and selling tobacco, a state that has the highest smoking rate in the nation. More than 30 percent of the population smokes, many burning through two packs a day.

One large downtown medical provider, Norton Health Care, plans to prohibit smoking outside its facilities as of May 1. That is causing debate among employees, patients and their families.

"It's the right thing to do," said Russell Cox, Norton's chief operating officer.

A few blocks away, another major hospital center, this one run by the University of Louisville, is likely to follow suit by fall, along with most metro-area hospitals, officials said. A citywide indoor smoking ban is to take effect in mid-2007.

Inside two of the city's largest hospitals, nurses are prominent figures in the controversy over smoking bans, and nationally they are being targeted to enroll in stop-smoking programs.

"This is not about shame and blame. Nurses don't imagine a life of addiction to the very thing they counsel people not to do," said Linda Sarna, a nursing professor at the University of California, Los Angeles who promotes an online initiative called Tobacco Free Nurses. Some 2,000 nurses nationwide have tried to stop smoking online.

Among nurses in Louisville, there are sharp divisions over smoking. Smokers often sneak extra breaks, say nurses who don't smoke and cover for them. Non-smokers also resent the smell of smoke on their colleagues as they care for patients.

"I don't have a lot of sympathy for [smoking]," said Anna Smith, who supervises 130 nurses in the university emergency room where about 25 percent of them smoke.

E.A. Torriero writes for the Chicago Tribune.

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