Stubbing out the cigarettes
Sep 26, 2007, 11:43
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For years, Tim Sacco endured gibes from co-workers in the radiation oncology unit. How could a man who witnessed the malignant effects of tobacco continue to suck into his lungs all those toxic chemicals? He'd tried to quit: going cold turkey, hypnosis, acupuncture, even laser treatments to his earlobes and fingertips. It wasn't until his employer, Kaiser Permanente, banished smokers from its Sacramento-area campuses in February, that Sacco kicked the habit, hopefully for good. "By doing what they did, having an environment here that is smoke-free, it gave me one more reason to try to quit," said Sacco, who works helping deliver radiation to stop tumor growth. On Oct. 1, Sutter Medical Center, Sacramento, will make the same sweeping changes at its two hospitals, psychiatric center and skilled nursing facility. UC Davis Medical Center will follow suit, making its 143-acre campus smoke-free July 1, 2008. Years in the planning, Sutter's move will force employees, visitors and patients into cars, onto sidewalks or other off-campus venues if they want to light up. Sutter also will provide low-cost smoking cessation classes open to all. The shift represents a sea change from hospital environments of decades past. "When I started working in hospitals in the 1980s, we used to sell cigarettes in the gift shop," said Jan Emerson, spokeswoman for the California Hospital Association. "It's been an evolution." Sutter Health officials insist the prohibition is not an attempt to wag a finger at tobacco users. "We aren't preventing anyone from choosing to smoke, but we aren't providing a location on our campus, because it's contrary to our mission," said Ekeshia Pittman, Sutter's smoking cessation program coordinator. But some at Sutter General Hospital this week might disagree. Jill Allcock, a registered nurse, feels the move is oppressive. During work breaks, she sits just outside the hospital's entrance and enjoys her Rockstar Energy Drink, Harry Potter novel and spicy Indonesian cigarettes. "We work our butts off upstairs, and this is where I come to escape," she said. "For people to 'tough-love' you, it's just not their right." The 41-year-old said that starting next week, she'll have to go out to her car in a garage across the street for her tobacco fix. "I plan on quitting smoking," she conceded, "but it's an addiction and very difficult to stop." Pushing smokers, particularly hospital gown-clad patients, out to the curb to smoke will be a public relations problem for hospitals, predicted Terri Maple, a surgery technician who smokes. Others seem resigned; some are almost enthusiastic. Enjoying a Marlboro ultra light during a visit to his hospitalized mother-in-law, 55-year-old Al Shepperd understands the ban, giving smoking's health effects and how much others hate it. "What are you going to do?" he asked, rhetorically. "When I started smoking back as a teenager, I wish I knew then what I know now." Hospital housekeeper Kim Biffle, who's smoked for 35 of her 47 years, sees the shift as an opportunity. "It gave me reason to quit," said Biffle, who sandwiched her Lean Cuisine meal between generic cigarettes during her 30-minute lunch break Monday. To help her prepare for the change, Biffle is taking Chantix, a drug that blocks nicotine receptors in the brain, in increasing doses over 12 weeks. Already, she said, she's cut back from two packs a day to one, and plans to spend lunch breaks inside to manage residual temptation. Research has shown that hospital smoking bans can, in fact, induce healthier habits. A 2000 study published in the Journal of the American Medical Association found that more hospital employees quit smoking after tobacco use was banned than did employees in workplaces where smoking was permitted. The Joint Commission on the Accreditation of Healthcare Organizations, a national regulatory agency, required hospitals to ban indoor smoking in 1993. The same research found that 41 percent of hospitals had gone further with campus-wide smoking bans, and most were offering smoking-cessation classes. Sutter Health, which operates 25 hospitals and nine medical foundations, mostly in Northern California, has instituted campus-wide bans in half of its facilities. About one-fourth of the remaining properties are considering similar policies, according to a spokeswoman. At Sutter Medical Center, unwitting smokers will be handed an information card about the ban and available programs to help them quit. At Sutter Center for Psychiatry, patients will no longer have access to their smoking paraphernalia. Instead, they will be offered nicotine replacement therapies, chemical dependency support and "wellness breaks" including stress reduction and relaxation techniques. Kaiser Permanente in Sacramento has taken a similar approach. Forty-six of their Northern California facilities -- including medical centers and outpatient clinics -- are smoke-free. That accounts for about 85 percent of their Northern California facilities; they expect to be nearly 100 percent smoke-free by next year. "The bottom line is that as a health care organization we really need to practice what we preach," said Barbara Halpin, Kaiser's director of health education. "The single most negative practice that has a negative impact on health is use of tobacco." The region's other large hospital system, Catholic Healthcare West, restricts smoking to designated areas outside its hospitals but has no ban currently in place, a spokeswoman said.
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