Structured Analysis of the Emerging Shift from Smoke-free to Smoker-free Policies in Georgia Hospitals Público

Abstract

The high rate of smoking-related deaths has encouraged policies prohibiting smoking in public and work places. Although hospitals seem obvious places for strict smoking policies, Georgia and other states have failed to implement total smoking bans in hospitals. In 1992, the Joint Commission on the Accreditation of Health Care Organizations (JCAHO) required hospitals to ban indoor smoking; however, an effect of this policy has been increased outdoor involuntary exposure to tobacco on hospital campuses. This creates a negative image for hospitals because it contravenes the expectation that hospitals should be free of such obvious health risk as involuntary smoking. While some hospitals have adopted smoke-free policies, others have adopted smoker-free policies, which, among other effects, deny employment to smokers. Currently, three Georgia hospitals have smoker-free policies while others consider the policy. This supports an inference that hospitals may be shifting to smoker-free policies. Under a three-step analytical framework grounded in descriptive research methodology, this study tests whether there is an emerging shift to smoker-free policies in hospitals in Georgia and nationwide. As a threshold step, it tests whether Georgia hospitals are shifting from smoke-free to smoker-free policies. Next, it assesses the prevalence of any detected shift. Finally, it measures any inherent impediments to any detected shift.

Table of Contents

TABLE OF CONTENTS ABSTRACT.................................................................................................................... Xi Chapter Page CHAPTER 1 Introduction ........................................................................................................ 1

Problem Statement............................................................................................... 7

Theoretical Framework.......................................................................................... 8

Purpose Statement.............................................................................................. 10

Research Questions............................................................................................. 10

Significance Statement........................................................................................ 10

Operational Terms............................................................................................... 13 CHAPTER 2 Introduction....................................................................................................... 14

History of smoking ban in U.S hospitals................................................................. 14

The impact of smoke-free hospital policies............................................................. 15

Prevalence of Smoke-free hospitals and healthcare facilities..................................... 20

Smoke-free hospitals in Georgia .......................................................................... 21

The new trend: Smoker-free policies in Georgia hospitals........................................ 22

Prevalence of Smoker-free Policies in U.S Hospitals................................................ 24

The Position of the Joint Commission on Smoker-free polices.................................. 25

Impediments to smoker-free policies.................................................................... 25

CHAPTER 3 Overview......................................................................................................... 33

Population and Sample...................................................................................... 33

Research Design............................................................................................... 34

Procedures....................................................................................................... 35 Instruments..................................................................................................... 35

Protection of Privacy.......................................................................................... 35

Data Analysis.................................................................................................... 35

Limitations........................................................................................................ 36 Delimitations..................................................................................................... 36 Summary.......................................................................................................... 36 CHAPTER 4 Introduction....................................................................................................... 37

Description of Sample.......................................................................................... 37

Results.............................................................................................................. 38

DeKalb Medical Center......................................................................................... 38

Gwinnett Medical Center...................................................................................... 39

Phoebe Putney Health System in Albany................................................................ 40

Position of Georgia Hospital Association on Smoker-free hiring Policy........................ 40

CHAPTER 5

Study Overview.................................................................................................. 41

Summary of findings........................................................................................... 41

Practical Implications.......................................................................................... 43

Recommendations for Future Study...................................................................... 43

Conclusions....................................................................................................... 44 APPENDICES

Appendix A: Approval Letter from Emory International Review Board........................ 46

REFERENCES..................................................................................................... 47

About this Master's Thesis

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School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palabra Clave	smoker-free policies Hospitals Comprehensive smoking ban Smoke-free policies Secondhand smoke Healthcare facilities Smoking ban Third-hand smoking
Committee Chair / Thesis Advisor	Butler, Susan O, Emory University Apicelli, Billy, Emory Hospital
Partnering Agencies	Emory University schools, faculty or affiliated programs Hospital or other health care provider

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