Research Institute, Bassett Healthcare, Cooperstown, New York 13326, USA. anne.gadomski@ bassett.org
J Hosp Med. 2010 Jan;5(1):51-4. doi: 10.1002/jhm.473.
Hospitals fear that transitioning to a smoke-free medical campus will decrease patient volume, particularly for patients who smoke. When our hospital campus, a 180-bed acute care facility located in a small town, implemented the smoke-free medical campus on July 1, 2006, we prospectively monitored inpatient and employee outcomes.
Inpatient volume, percentage of inpatients who currently smoke, nicotine replacement therapy (NRT) orders (obtained from electronic medical records), the number of inpatients who signed out against medical advice (obtained from incident reports), and employee tobacco-use rates from annual occupational health assessments were compared pre-ban and post-ban.
The monthly average for the percentage of inpatients who currently smoke has been steady, at 20% to 22% post-ban. NRT orders tripled after the ban. There was no significant change in the rate of inpatients who signed out against medical advice pre-ban and post-ban. During the year preceding the ban, 150 employees participated in a cessation program offered by Employee Health. The pre-ban employee self-reported smoking rate for the same 4-month period (March-June) was 14.3% in 2005, 14.8% in 2006, and 9% in 2007 (P < 0.0002).
Implementing a smoke-free medical campus did not adversely affect inpatient volume (even among smokers), significantly increased inpatient NRT use, and decreased hospital employee smoking rates.
医院担心将医疗园区转为无烟区会减少患者数量，尤其是吸烟患者。当我们的医院园区（一家位于小镇上的 180 床位急症护理机构）于 2006 年 7 月 1 日实施无烟医疗园区时，我们前瞻性地监测了住院患者和员工的结果。
我们比较了禁烟前后的住院患者数量、当前吸烟患者的比例、尼古丁替代疗法（NRT）处方（从电子病历中获得）、违反医嘱出院的住院患者数量（从事故报告中获得）以及年度职业健康评估中的员工烟草使用率。
禁烟后，当前吸烟患者的月平均比例一直稳定在 20%至 22%。禁烟后，NRT 处方增加了两倍。禁烟前后，违反医嘱出院的住院患者比例没有明显变化。在禁烟前一年，有 150 名员工参加了员工健康部门提供的戒烟计划。同一 4 个月期间（3 月至 6 月），2005 年的禁烟前员工自我报告吸烟率为 14.3%，2006 年为 14.8%，2007 年为 9%（P<0.0002）。
实施无烟医疗园区并没有对住院患者数量产生不利影响（即使是吸烟者），显著增加了住院患者 NRT 的使用，并降低了医院员工的吸烟率。
