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Joint Commission publication assists facilities in enforcing smoking bans

April 27, 2011
by Gary A. Enos, Editor
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New guide addresses facilities’ implementation challenges

Seeking to assist the growing number of health facilities that have made their properties completely smoke-free, The Joint Commission has released a guide designed to help facilities that face enforcement challenges once their tobacco-free policies have taken effect.

Keeping Your Hospital Property Smoke-Free, available for free download via The Joint Commission’s website (, is meant to fill an information gap on the issue of tobacco policy implementation, as several existing guides focus more on policy establishment than on enforcement.

The national accrediting organization has worked on a number of grant-funded projects in this subject area in recent years; a collaborative survey it conducted with the Henry Ford Health System found that 45 percent of participating hospitals had implemented a total ban on smoking on their property as of 2008. The Robert Wood Johnson Foundation and the Flight Attendant Medical Research Institute have supported The Joint Commission’s efforts in this area.

Scott Williams, PsyD, associate director of The Joint Commission’s Division of Healthcare Quality Evaluation, says research has indicated that behavioral health facilities indeed can implement a successful smoke-free policy.

“There is a lot of mythology that has been built around the difficulties of providing a smoke-free environment in mental health settings, including addiction,” says Williams. “From what I have read, the reality of implementation tends to be a lot less horrible than people imagine.”

The new guide, produced in conjunction with the Henry Ford Health System, is designed to assist healthcare facilities in training their staff members to respond to a variety of enforcement scenarios, such as how to defuse a potentially volatile situation with a patient’s visiting family member who violates the ban.

“You have to make this a global policy,” Williams says. “You really try to get the [entire] staff to buy into the idea.”

Research also has indicated that placing a smoking ban in a broader context of creating an environment that reinforces wellness can assist in facilities’ enforcement effort. “People understand, if it is rolled out as part of a larger wellness program, why a hospital would not want to allow smoking on its property,” says Williams.