Are Canadian hospitals leading by example to promote smoke-free hospital properties? Rationale, challenges and opportunities

Knowing the devastation of tobacco use and the evidence to support proven tobacco reduction approaches, such as smoke-free hospital property policies, are Canadian hospitals doing all they can to lead by example? This paper explores the background and diverse views on smoke-free hospital properties to illuminate the rationale, challenges and opportunities of this important healthcare initiative. Currently, some hospitals in Canada have transitioned to smoke-free properties; however, many still allow smoking in designated areas or do not have any policies in place. Fear, speculation and reservations around compliance, leadership, negative perceptions, safety and patient care are some of the reasons that appear to be stalling progress in many healthcare facilities; nevertheless, the evidence supporting the implementation of comprehensive smoke-free hospital property policies far outweighs the concerns. Key considerations for successful policy implementation include: leadership and enforcement; systematic tobacco dependence treatment; and elimination of designated smoking areas (DSA’s) and policy exclusions. Hospitals are ideal institutions to continue the downward trend in tobacco use prevalence. Through smoke-free property policies, Canadian hospitals can make a significant impact and lead by example in their communities by creating opportunities to promote healthy choices, protecting individuals from exposure to environmental tobacco smoke (ETS), supporting those who are trying to quit or who have quit smoking and by sending a clear message that smoking and exposure to tobacco smoke is harmful. As witnessed though the learnings of leading hospitals, transitioning to a smoke-free hospital property is achievable.