Smoke-free or not: a pilot evaluation in selected Beijing Hospitals

BMC Public Health

Na Zhao²  Jiangbo Wang²  Jingyan Yang¹  Anjie Zhen¹  Michelle R Kaufman¹  Frances A Stillman¹ 

[1] Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 4th floor, Baltimore, MD 21205, USA;Chinese Association for Tobacco Control, Beijing, China

关键词: Policy assessment;    Passive nicotine monitors;    Evaluation;    Hospitals;    Smoke-free;    (MeSH terms);   

Others  :  1161658
DOI  :  10.1186/1471-2458-13-964

 received in 2012-12-18, accepted in 2013-10-11,  发布年份 2013

【 摘 要 】

Background

China enacted a policy to ban smoking in hospitals. The Chinese Association for Tobacco Control (CATC) developed a program to help hospitals implement this policy. They conducted a program and an assessment in 3 Chinese cities (Beijing, Shanghai and Guangdong). A more in-depth evaluation was implemented with a sub-sample of hospitals in Beijing (N = 7) to provide an independent assessment. This independent assessment focused on evaluating policy development and an assessment of secondhand smoke (SHS) to determine compliance with the smoke-free policy initiative.

Methods

Pre- and post-survey data were collected at each of the selected hospitals with a total sample of 2835 physicians at pre-intervention and 2812 at post-intervention. Smoking rates pre- and post-policy implementation, change in knowledge, attitudes and practices among physicians, and compliance with policy were assessed. Measurements of airborne nicotine concentrations in selected locations in each hospital were taken: main hospital lobby; main outpatient center; emergency waiting room; and stairwell adjacent to a large inpatient ward. Hospital policies were collected, translated and rated for incorporated components necessary to implement a smoke-free policy.

Results

Physicians’ smoking rates decreased and attitudes towards tobacco control improved significantly from pre-to post-intervention. Smoking was still reported in certain areas of the hospital with 96% of passive nicotine monitors as well as self-report indicating continued smoking. Nicotine levels ranged from <0.0056 to 3.94 μg/m³), with an overall mean of .667 μg/m³. Hospitals that established stronger policies seemed to have lower levels of nicotine, suggesting a relationship between policy development and compliance. This finding is interesting but just suggestive and requires further investigation to truly demonstrate if stronger policies improve compliance and produce better outcomes.

Conclusion

As implementation strategies for smoke-free environments are improved and more resources are focused on hospitals, China is making progress toward achieving smoke-free hospitals. Using a model program could increase the prevalence of SHS policies across China. However, relying only on survey data may not provide an accurate assessment of this progress, and more extensive evaluation efforts are useful to understand how change can and does occur.

【 授权许可】

   
2013 Stillman et al.; licensee BioMed Central Ltd.

【 图 表 】

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