Academic journal article Australian Health Review

Effect of a Smoke-Free Policy on Staff Attitudes and Behaviours within an Australian Metropolitan Health Service: A 3 Year Cross-Sectional Study

Academic journal article Australian Health Review

Effect of a Smoke-Free Policy on Staff Attitudes and Behaviours within an Australian Metropolitan Health Service: A 3 Year Cross-Sectional Study

Article excerpt


Tobacco remains a significant cause of death and disability in Australia, and approximately 3.3 million Australians still smoke.1 The economic impact of smoking was estimated in 2012 to be $5.05AU billion annually, with 31.6% of this amount related to tangible costs (e.g. absenteeism, health care, fires).2 Long-term exposure to tobacco smoke in adults has been linked to lung cancer, adult-onset asthma and heart disease.3

A worldwide commitment to reduce the effect of secondhand smoke has been led by the introduction of smoke-free workplaces and environments. Smoking restrictions have slowly been implemented in Australia since 1988.4 Smoking bans on school grounds, waiting areas for public transport and within sporting grounds were introduced from 2005;2 a total smoking ban within enclosed public places was enacted in 2007.2 Following the implementation of these bans, healthcare environments were identified to model healthy workplaces and play a supportive role in aiding staff and patients to reduce and quit smoking.5 Having healthcare services implementing similar initiatives emphasises the roles of healthcare workers in tobacco control initiatives while modelling a healthy workplace.6

Smoke-free policies have positively changed employees' smoking behaviour worldwide.7,8 Research has shown that smoke-free policies result in a reduction in employee cigarette consumption9,10 and increase smoking cessation.5,9 Workplaces without smoking restrictions have been strongly associated with a greater number of employees smoking,11 but restrictions in workplace smoking directly relate to employees' intention to stop smoking.12,13 One organisation reported improvements in workplace interpersonal relationships directly resulting from smoking bans.6 Employees in smoke-free workplaces also are more likely to enact similar bans in their own homes.8

During the implementation of a smoke-free workplace policy in the hospitality sector, attitudes to the policy were initially negative, despite workers understanding the rationale for its introduction.14 Healthcare workers have also exhibited negativity to smoke-free workplaces despite their knowledge of the health benefits.15 Healthcare environments implementing smoke-free policies require an employee to leave the grounds or to smoke in a dedicated place onsite. This often causes concerns of continuity of patient care because of the amount of time it takes to leave the workplace for a cigarette break. This concern has made the implementation of smoke-free policies difficult within the health sector.16 There has been little investigation within Australia about worker attitudes during the implementation and maintenance of a smoke-free health service.

The Frankston Mornington Peninsula Smoking Prevention & Cessation Strategy was developed in 2009 in Victoria, Australia. The Frankston Mornington Peninsula Smoking Prevention & Cessation Strategy aims to work collaboratively across sectors to address tobacco control using a multistrategic approach, including smoking prevention and education, integrated smoking cessation support services, promotion of smoke-free environments, capacity building and advocacy. One of the initial strategies of this approach was supporting Peninsula Health to implement a smoke-free environment policy. Local leadership for this change was through the Health Promotion team, with executive management and human resources support. Peninsula Health currently employs over 5000 staff and has several hospital and community-based sites. In 2009, a new community health site was built and a trial of a smoke-free policy was implemented at this site. All staff were informed in 2010 of this single site trial and notified of the move towards being smoke free service wide. Staff were informed of the date this change would take place through email and flyers, and were informed of local QUIT services before the implementation if they were interested in quitting smoking. …

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