1. Smoke-Free Campus Steve Wantz Sam Flanders, MD Patty Hollingsworth Debi Hudson, BS, RRT

2. Cigarette smoking is the chief single avoidable cause of death in our society and the most important public health issue of our time. C. Everett Koop, M.D. U.S. Surgeon General 1981-1989

3. What do we mean by Smoke-free? Smoking is prohibited in all Clarian Health buildings, company vehicles, and on the property/grounds of Clarian Health Includes: campus walkways, parking garages, tunnels and leased property.

4. How is it different from current policy? Current Prohibits smoking inside any facility Allows smoking in designated areas outside New Prohibit smoking on the grounds, in parking garages, walkways, and company vehicles No designated smoking areas

5. Secondhand Smoke (SHS) Is the 3 rd leading cause of preventable death in the US after active smoking and alcohol use, with an estimated 53,000 deaths annually

6. SHS Some constituents remain suspended in air and some are deposited onto animate and inanimate surfaces (walls, drapes, clothes, hair). The deposited material may remain on a surface but can also be emitted back into ambient air.

7. Adverse effects of smoke residue on a person’s body May cause sensitization &/or allergic skin eruption such as dermititis. Inhaling residues from clothing/hair may trigger adverse effect on upper airways, irritation of eyes, throat, ears and may cause or exacerbate asthma.

8. Possible Policy Types Facility/grounds All grounds will be smoke-free HR Staff will be prohibited from smoking during their shift, including rest and lunch breaks

9. What are other hospitals doing?

10. Other Completely SF Hospitals 1987-Mayo Clinic (MN) 1989-MD Anderson (TX) 1996-United Memorial Hospital (MI) 1994-Franklin Memorial (MA) 1991-Duke University (NC) 1998 –Battle Creek, Northern, Pennock Hospital,(MI)Joliet Hospital (IL) 1999-Spectrum, U of MI, Holland Hospital, Hackley Hospital, Foote Hospital (MI) 2000 Hayes Green Beach Memorial, Charlotte

11. What are other Indiana hospitals doing? Currently 9 hospitals within Indiana are smoke free inside and out All Community hospitals, St. Francis, St. Vincent and Wishard are all in the process of implementing completely SF policies by summer of ‘05

12. What smoke free (inside and out) hospitals told us were keys to success: Collaborate with other area health care providers Identify smokers at admission Offer tobacco cessation counseling to all inpatients, family members, staff & community Provide pharmacotherapy to patients, visitors, & staff Develop tracking mechanisms to document effectiveness

13. Keys to success... Enforcement Supportive versus punitive Administrative and Physician role models Clear definition of smoke-free area Intervention cards Signage Employee compliance Patients and guest follow the example of your employees Consistent policy for all staff Whatever your policy, enforce it

14. What is being done at Clarian Physician Order Group Admission Notice Compassionate Policy Web-based training for Clarian Clinicians (MD’s, nurses, respiratory, etc.) Referrals to programs/resources Actively participating in collaboration with other local hospitals Considering subsidy for OTC medications Visitor packets will be available Employee cessation program available Outpatient cessation program available

15. Policy Implementation Plan Visitors Notification at points of entry “Please extinguish all smoking materials before leaving your car – Clarian is a Smoke Free Campus” Web page promotion Manager and Staff training on tips and scripts for communicating smoking policy In emergent situation nurses will offer nicotine replacement to visitors Survival kits with coupons for nicotine replacement available

16. Policy Implementation Plan Patients Notification in pre-admission packets with recommendations to discuss cessation options with attending physician or nurse Waiver at all points of admission Nurse assessment of smoking status Physician Order sets

17. Making hospitals smoke free isn’t about forcing people to quit smoking It’s about creating a safe environment