Hospital Smoking Bans a Sign of Things to Come Print
News/Features - Local News
Wednesday, 10 May 2006 02:58
The smoking bans put in place last week at Genesis and Trinity hospitals are the first signs of what is almost certainly an inevitable end: smoking being forbidden in all enclosed public spaces in the Quad Cities.


According to the American Lung Association, 48 states restrict smoking in government buildings, and 31 states restrict smoking in private workplaces. (Illinois and Iowa restrict both.) And while the Quad Cities aren’t smoke-free yet, Genesis’ and Trinity’s policy to go entirely smoke-free on May 2 might put the gears in motion for citywide indoor bans.

The United States hasn’t passed federal nonsmoking legislation, but 14 states have banned smoking in all enclosed public spaces, such as bars, restaurants, and workplaces. California was the first to ban smoking in 1994. Since then Colorado, Connecticut, Delaware, Hawaii, Maine, Massachusetts, Montana, New Jersey, New York, Rhode Island, Utah, Vermont, and Washington have all gone smoke-free.

Kathy Drea, director of public policies for the American Lung Association of Illinois, said that she expects smoking in public places to be banned throughout the United States within five years. “Since the beginning of this year alone, we’ve had about one state go smoke-free a month,” she said.

In 2004, the Republic of Ireland became the first country in the Northern Hemisphere to ban smoking in all enclosed spaces. Countries including Italy, New Zealand, Spain, and Sweden have followed suit. The United Kingdom will begin its enclosed-places smoking ban in summer 2007.

Walking the Talk

Jim Lehman, vice president of quality at Genesis, said that there has been an increasing number of complaints over the past several years about having to walk through clouds of smoke to enter hospital buildings. Both Trinity and Genesis officials felt that because they are health-care providers, allowing people to smoke on their premises wasn’t sending a positive message, even though smoking inside the buildings was eliminated many years ago.

“We decided to become tobacco-free externally and internally because it’s the right thing to do,” said Berlinda Tyler-Jamison, president of Trinity Health Foundation. “We are a health-care facility, and our mission clearly states that we exist for the health of the community, and this is just Trinity ... walking that talk.”

Edgerton Women’s Health Center and one Vera French facility have also gone smoke-free.

Vera French CEO Andy Lenagham said that the policy was only enacted at the Central Park Avenue location, which is adjacent to the Genesis West Campus. The Central Park Avenue location is nonresidential, offering therapy sessions during the day. Therefore, he said, the smoking ban will not have a major impact on patients.

Lenagham added that there are no plans to ban smoking at Vera French’s other three locations, especially Pine Knoll, a residential treatment facility for mental-health patients. “Compared to the general population, there are a larger amount of mental-health care patients that are serious smokers,” Lenagham said. “It would be very hard to take smoking away from them.”

Lehman said that some Genesis employees were initially angry at the smoke-free policy. According to The Smokers Club – a national smokers’ rights organization – 21.7 percent of adult Iowa citizens and 24.3 percent of adult Illinois citizens use tobacco products. Genesis employs 5,000 workers and Trinity employs 3,000 workers, so the smoking bans will likely affect at least 1,500 employees.

“We know we have employees who smoke, and certainly we are tying to make this transition for them as smooth as possible,” Trinity’s Tyler-Jamison said. “We’ve built in a number of support mechanisms for them.”

Trinity and Genesis are offering free tobacco-cessation programs and support groups for employees who want to quit. Along with that, employees are able to buy stop-smoking aids such as nicotine gum and patches at cost.

“We’ve trained our other staff to be aware of people who are trying to quit and the fact that they get irritable and cranky sometimes,” Lehman said.

Lehman, though, isn’t worried that smokers who are irritable will affect performance. He said that the policy change will have a positive effect on productivity and efficiency because smokers tend to take more breaks than nonsmokers.

For employees that choose not to quit, aids are being given to help decrease their urge to smoke – such as hard candy, straws, and gum. They’ll also be given tips on how to overcome urges. The same products will also be given to patients and visitors who use tobacco products.

The nonsmoking policy may cause some visitors to leave campuses to use tobacco, which is something Lehman said Genesis is just going to have to deal with. “I think that it’s certainly not right or fair to people who come here expecting to receive top-quality care and have to be exposed to secondhand smoke. So, I think those are just issues we’ll have to work through, and hopefully people will be reasonable, and I think they will,” he said.

Lehman said Genesis’ most recent policy stated smokers were to go 30 feet from any entrance to smoke. Genesis and Trinity placed designated small huts around their campuses for people to smoke in. However, Lehman said roughly half of smokers didn’t comply with the policy and would stand near the entrances or a few feet away when they smoked.

Trinity and Genesis both are taking similar approaches to enforce the new policy. “If they see someone who’s not complying with our policy ... rather than going up to them and get started in an argument, they can just hand them a card that says we’re a tobacco-free organization, please observe our policies and don’t smoke on our property,” Lehman said.

“For this to be successful, we have to have employees enforce it and enforce it passionately,” Tyler-Jamison said. “I think that it is something that we stress.”

A possible reaction to the policy will be for smokers to migrate to areas around the hospitals to smoke. Some Trinity and Genesis campuses are surrounded by neighborhoods, and hospital officials do not want neighborhoods to suffer from the policy change. Lehman and Tyler-Jamison said that citizens who live around the hospitals are to contact the hospitals if numerous smokers litter neighborhood with cigarette butts. “We expect them [smokers] to be good citizens,” Tyler-Jamison said.

Lehman said in an e-mail that Genesis has a four-step corrective-action process for employees who are caught smoking on campus grounds. The first step is a verbal warning, with consequences progressing up to termination.

The Bigger Picture

City-wide smoking bans have become more common in Illinois. Chicago officials banned smoking in January in all public indoor places. However, most public establishments are given until July 2008 to implement the ban. Smoking bans were also placed in Springfield, DeKalb, Skokie, Highland Park, and Wilmette.

In Iowa, Ames banned smoking in most public places, but the state supreme court ruled that the municipalities did not have the authority to pass such bans, thus invalidating the city’s ordinance. However, more than 95 percent of restaurants in Ames are currently completely smoke-free.

Moline has been the only Quad Cities community in which a smoking ban has been proposed by a member of a legislative body. Michael Carton, Moline’s Ward 2 alderman, made a motion to begin discussions on banning smoking from workplaces and restaurants last December. However, none of the other aldermen seconded the motion, which shut down discussion.

“I figured I would wait until after the next elections are done to begin discussions again,” Carton said.

Carton said that while city officials were not interested in a smoking ban, a large number of Moline citizens sent him e-mails and letters, with 80 percent supporting a smoking ban. The next elections won’t take place until April, so Carton will have to sit tight on a possible smoking ban. “I just hope that the aldermen will listen to what citizens are saying,” he said.

Michael Crotty, Moline’s Ward 6 alderman, said Carton didn’t do the necessary research to propose the ban. Crotty said that before proposing a smoking ban, Carton should have gathered information about the cost, monitoring mechanisms, and an implementation strategy.

“When no one seconded the motion, it’s not like we were saying we were in favor of smoking,” Crotty said. “There are just a number of things we need to look at before we begin discussing it.”

Tobacco Free QC, run by local health organizations including the Rock Island and Scott County health departments, is a leading organization for a smoke-free Quad Cities. Jennifer Johnson, health educator for the Rock Island Health Department, said one of Tobacco Free QC’s main goals is “trying to eliminate the social acceptability of smoking.” Members of the organization give presentations to classrooms and kids of all ages, publish brochures with tips on quitting smoking, offer cessation advice, and work with local law enforcement to make sure tobacco distributors are not selling to minors. (A wall of shame is posted on its Web site, (http://www.tobaccofreeqc.org), with a list of places in the Quad Cities that have sold to minors.)

One of the major things that Tobacco Free QC does is talk to local restaurants about going smoke-free. The organization publishes a dining-out guide of local dining establishments that are completely smoke-free – 244 total. However, roughly half of the restaurants listed are fast-food establishments, a vast majority of which were already smoke-free when the organization was established in 1998.

JaNan Less, community-health consultant for the Scott County Health Department and project coordinator for Tobacco Free QC, said that a few of those fast-food establishments in the Quad Cities, such as McDonald’s and Hungry Hobo, allowed smoking before Tobacco Free QC spoke with managers and owners about switching to a smoke-free environment. Less said that Tobacco Free QC doesn’t talk to restaurants one-on-one anymore except by request. Now, the organization provides information about the benefits of being a smoke-free restaurant to restaurants that receive a new license or renew a license. Less said that the bigger goal for Tobacco Free QC is to ban smoking in all public spaces throughout Iowa and Illinois.