HOSPITAL SMOKING BANS AND EMPLOYEE SMOKING-BEHAVIOR - RESULTS OF A NATIONAL SURVEY

Objective.-To examine the impact of workplace smoking bans on smoking behavior of employees. Participants.-A total of 1469 current or former smokers (intervention group) employed in smoke-free hospitals and 920 current or former smokers (comparison group) employed in non-smoke-fr ee workplaces were surveyed to determine smoking behavior. Design.-Thi s cross-sectional study is part of a larger, ongoing prospective study , The study design was quasi-experimental. We randomly selected sites consisting of a hospital and a corresponding community. Furthermore, w e randomly selected subjects from hospitals and their corresponding co mmunities. Main Outcome Measures.-Postban quit ratio and progression a long the stages-of-change continuum. Methods.-The Cox proportional haz ards model was used to compare the postban quit ratio between the inte rvention and comparison groups. The Cochran-Mantel-Haenszel analysis o f variance statistic was used to compare groups on the stages-of-chang e variables. Results.-Beginning with the smoking ban and continuing fo r 5 years after implementation, statistically significant differences in the postban quit ratio were observed between employees of smoke-fre e hospitals who were smokers and counterparts in the community (P<.001 ). Despite preban differences in smoking intensity, the overall differ ence in postban quit ratios remained significant even after multivaria te adjustment for socioeconomic, demographic, and smoking intensity va riables. For those sites that were 5 years postban, the quit ratio was 0.506 in smoke-free work-places compared with 0.377 in workplaces whe re smoking was permitted. In all but 1 category, the intervention grou p was further along the stages-of-change continuum toward quitting smo king than the comparison group (P<.001). Conclusion.-American hospital s' experiences with smoking bans, which directly affect more than 5 mi llion workers, should be examined by other industries as a method of i mproving employee health. Workplace smoking bans could also be effecti ve in saving lives, reducing health care costs, addressing safety conc erns, and decreasing operating and maintenance expenses of employers.