Resources

Hospital Support Kit

The Maine Tobacco-Free Hospital Network is pleased to present you with our new tobacco-free hospital support kit.  The purpose of these resources is to provide you and your staff with free information and materials that will make it as simple as possible to move towards and/or implement a 100% tobacco-free campus policy.  Many of the items in the support kit are provided as Word documents below, so your organization can customize them to fit your needs.

Hospital Support Kit Materials: 

If you would like to receive a free hard copy of the Support Kit, please contact the Maine Tobacco-Free Hospital Network by phone or email.

Other MTFHN Resources:

MTFHN Tobacco-Free Magazine Stickers

Stickers that state "tobacco product advertising is not supported by this facility" can be ordered for free by calling or emailing the Maine Tobacco-Free Hospital Network.  Placing stickers on magazines or including a small sign in waiting rooms is a great way to show your patients, visitors and community that you do not support tobacco advertising.  This message is especially important since we know that often these ads are targetting children and teens.  A partial list of magazines that contain tobacco advertisements can be found here.

Additional Hospital Resources:

The Maine Hospital Association has adopted a position statement around tobacco-free hospitals.  You can download the statement here or view it at www.themha.org

The Joint Commission released a new tool kit for hospitals looking to adopt a smoke-free or tobacco-free policy.  Learn more about the new resource on The Joint Commission Website, you can download the "Keeping Your Hospital Property Smoke-Free: successful strategies for effective policy enforcment and maintenance" booklet here.

Links

The Maine Tobacco HelpLine
Free cessation resources for your patients, staff, and communities may be obtained by calling the Maine Tobacco HelpLine.

Partnership for a Tobacco-Free Maine (PTM)
Keeping it local, PTM offers resources, especially for the target population of those suffering from chronic disease, who are often hospitalized. PTM provides facts on higher rates of smoking, and/or more dramatic health consequences from secondhand smoke for those with diabetes, heart and cardiovascular disease, asthma, COPD, and physical and/or mental disability.

Healthy Maine Partnerships (HMP)
Your local Healthy Maine Partnership can provide resources for developing and implementing a tobacco-free policy. Find your local HMP on our homepage – they can help get your hospital/medical center started toward becoming tobacco-free!

The Maine Hospital Association (MHA)
The Maine Hospital Association represents 39 community-governed hospitals in Maine. Formed in 1937, the Augusta-based, non-profit Association is the primary advocate for hospitals in the Maine State Legislature, the U.S. Congress, and state and federal regulatory agencies. It also provides educational services and serves as a clearinghouse for comprehensive information for its hospital members, lawmakers, and the public. MHA is a leader in developing health care policy and works to stimulate public debate on important health care issues that affect all of Maine's citizens.

The Maine Environmentally Sustainable Hospitals Network (MESHNet)
A part of the Maine Chapter of the Physicians for Social Responsibility, MESHNet offers trainings and events addressing environmentally associated topics for hospitals, such as recycling hospital blue wrap, and addressing environmental air quality.

Maine Medical Association
The MMA is a voluntary association of over 2000 Maine physicians serving the profession and the public since 1853.

The Tobacco Control Network (TCN)
This comprehensive website includes state-specific resources around hospitals going tobacco free. Look for the Maine Tobacco Free Hospital Network to have reciprocal links soon!

The Washington Health Foundation
The state of Washington has produced a resourceful website for hospitals and health systems seeking to become tobacco-free. Especially helpful are the “working with” links for different sectors of your hospital/medical center community.

Smoking Cessation Leadership Center
The University of California-San Francisco established the Smoking Cessation Leadership Center, which echoes some of the same resources of the Washington Health Foundation. It also provides links on becoming tobacco-free in a psychiatric health care setting, and provides resources for smokers to quit, as well as clinicians for helping addicted patients quit.

University of Arkansas for Medical Sciences
The University of Arkansas for Medical Sciences has created a smoke-free hospital toolkit, citing dozens of resources, including timelines for establishing and implementing a policy for your hospital/medical center, communication around your policy, and providing support for employees trying to quit (among other resources).

Tobacco-Free Living in Psychiatric Settings: A Best-Practices Toolkit Promoting Wellness and Recovery

Smoking and Mental Illness
This message from David S. Proffitt, former superintendent of Riverview Psychiatric Center, and current CEO of The Acadia Hospital, explores why psychiatric settings should act in support of healthy recovery from all addiction, including tobacco use. Riverview Psychiatric Center has been a tobacco-free facility since 2007.

Tobacco-Free: Hospital versus Mosque
Read about how Saint Raphael’s hospital in New Haven, CT has banned smoking on the sidewalks surrounding the hospital in an urban area – and how a nearby mosque is getting questioned for the same decision.

Implementing a smoke-free medical campus: impact on inpatient and employee outcome

FAQs

Does every employee know about this policy?
Every employee, visitor, volunteer, and contractor should know about your tobacco-free policy! Be sure to make the policy known to current employees as well as including it in new employee orientations and trainings.

I currently use tobacco – does this mean I have to quit?
Be clear that this is not about the tobacco user, but about the tobacco itself. While your policy may make it more difficult for an employee to smoke, it does not require that anyone quit. If, however, your hospital offers any resources such as Nicotine Replacement Therapy (NRT), counseling, or prescription medications to help someone quit, advertise this in your policy.

Can I use tobacco in my car while parked on hospital property?
Often the last bastion keeping a hospital from being 100% tobacco-free is the personal vehicle clause. While some hospitals choose to include the parking areas and subsequently, the vehicles in them, in their policies, others choose to allow employees and visitors this one personal, private area in which to smoke.

If second or third-hand smoke is a reason for your policy, however, including your parking areas and the personal vehicles in them may be applicable. People who sit in their cars to smoke often enter the hospital with a significant amount of smoke on their clothing which can be problematic for patients and staff. Your hospital may have, or may consider a fragrance or odor policy that includes tobacco smoke.

Where can I use tobacco?
Be specific about where they can use tobacco off-campus. If your hospital campus has designated smoking areas, then include these in your policy language and ensure they are clearly marked so tobacco users are aware of where they are to go to smoke.

How will I know I’m not using tobacco on hospital property?
Again, specificity is key here. Some policies include that tobacco users must be a certain distance away (50 feet or 20 paces, for example), while others designate property lines via signage or even paint lines.

If I see someone using tobacco on hospital property, what should I do?
Enforcement is usually up to a specific department, such as Security. Employees should know, however, that they are to inform someone from the appropriate department to address a violation of the tobacco policy. Other hospitals include all staff in enforcement, such as a “See Something, Say Something” policy. No matter which kind of policy you have, be sure to identify who is responsible for enforcement, as well as the chain of command, should a user remain non-compliant after having been informed of the policy.

How will the policy be enforced?
Regardless of the policy you choose to adopt, it is crucial that you address enforcement of the policy seriously, with consistent and prompt response to any violation. Enforcement can run the gamut from “see something, say something,” giving everyone on site the chance to enforce the tobacco-free policy, to assigning enforcement to a particular department such as Security or Maintenance. Appropriate signage or physical boundaries (i.e. painting a line 50 feet away from the doorway or posting signage on all buildings) should also be used to reinforce the policy. See the Available Signage section for sample signs and templates.

Successful enforcement of the policy requires effective communication, and also depends upon the consideration, thoughtfulness, and cooperation of everyone.  Enforcement language should be included in the text of the policy. All must share in the responsibility for adhering to, and enforcing the policy. Any problems should be brought to the attention of the appropriate supervisor and/or department head to ensure violations are handled promptly, with consistency in the manner that each violation is addressed.

Both passive (i.e., voluntary compliance, signage, etc.) and active (i.e., inclusion in employee manuals, visitor guides, etc.) enforcement should be included in the process of addressing tobacco-use and prevention on the campus.

Do people who smoke get longer breaks to leave hospital property?
Many companies have employees who smoke, and many companies allow employees to take some sort of break or breaks during the workday. The question often arises whether employees who smoke should, or must, be given extra breaks. Some employees even wonder whether smoking is a protected disability that must be accommodated under the Americans with Disabilities Act. The answer to both questions is "no".

According to the Maine Department of Labor: “Employers must give employees the opportunity to take an unpaid rest break of 30 consecutive minutes after 6 hours worked if 3 or more people are on duty. An employee and employer may negotiate for more or less breaks, but both must agree (this should be put in writing). No coffee, bathroom, or smoking breaks are required.”

No matter what policy your hospital chooses, all allotted breaks must be equal for both smokers and non-smokers, so any additional breaks provided to employees during the course of the day should be offered to every employee consistently and with equal allotment times, regardless of smoking status.

I would like to quit smoking – where can I get help?
If your hospital or medical center offers resources such as counseling or tobacco treatment medications,(including nicotine replacement medications), advertise this in your policy and throughout the campus. Let employees know exactly what is offered, and the cost/barriers, if any. Also, if your hospital offers any incentives to quit, such as insurance benefits, reimbursements, or special recognition, advertise this as well. For local resources and information on Quit and Win programs your hospital may qualify to participate in, contact your local Healthy Maine Partnership. In addition, all Maine citizens are eligible for free counseling and support from the Maine Tobacco HelpLine, by calling 1-800-207-1230. The Maine Tobacco HelpLine has been proven effective in helping people quit through individualized counseling, follow up phone calls and utilization of evidence-based treatment methods.

Why is the hospital going smoke-free?
For hospitals, this is a simple answer of health risk prevention – smoking and tobacco use continue to kill more people than alcohol, cocaine, crack, heroin, homicide, suicide, car crashes, fires, and AIDS combined. It continues to be a factor in heart and lung diseases, cancer, and stroke. The financial cost of health care and lost employee productivity is estimated at $97.2 billion per year in the United States. Additionally, because the mission of a health care facility is on healing, allowing patients to smoke violates this goal. Patients who smoke take longer to heal from surgical and non-surgical wounds, broken bones, and are more susceptible to wound infection and other complications than non-smokers.

Why was smoking selected versus other health risks?
Most hospitals want to set a healthy example to their communities, patients, visitors, and staff. Tobacco use is the number one preventable cause of death and disability in the country. As a health care leader in the community, offering services in a caring, efficient manner, it is evident that preventable risks such as tobacco use be addressed for the benefit of staff, patients, and visitors.

Given the stress that families face during hospitalization, how does this policy support our commitment to “patients and families”?
The mission of the hospital remains one of supporting healthy behavior that is not consistent with offering patients or visitors a place to smoke. If your hospital offers tobacco treatment resources to staff as well as to visitors, advertise it. Access to counseling and medications can aid in cessation efforts for everyone. Use of nicotine replacement can be a very effective temporary tool for those who feel they need it. It also may be very helpful for family members who are at the hospital during a long-term stay who need support being in a tobacco-free environment.

Some hospitals offer pagers to family members of patients in critical care who leave the hospital to smoke. In the event of an emergency, the pager will activate, alerting the family member to return inside.

FAQ information provided in part by Blue Cross/Blue Shield of Minnesota and University of Arkansas Medical School.

Available Signage Templates

For your convenience, the Maine Tobacco-Free Hospital Network provides signage templates for your campus to use to help increase awareness of your tobacco-free policy. Download the signage templates.