Introduction
Tobacco usage takes millions of lives annually worldwide with 488,000 deaths annually in the US alone. The healthcare cost of tobacco usage is estimated at $300 billion dollars annually (Dennis 2015). The number of smokers in the world are expected to rise to 1.8 billion by 2020. Although people know the health risks of this highly addictive habit, they still choose to smoke. However, not only the smokers are exposed to the dangerous health risks and the people around them are also paying the price. Tobacco smoke affects everyone near a smoker both in public and in enclosed spaces.
A person affected by two environments, the home and the workplace, that affect the individual’s health. Most people spend the majority of their time at work estimating 40-50 hours a week. Therefore, the work place is an important environment that should be safeguarded for the health of the workers. Healthcare facilities have a particularly sensitive environment which should be protected for the health of the patients as well as healthcare workers. Due to the amount of time patients and health workers they spend in the hospitals, smoke in the environment can affect their health.
Workplaces are made of diverse cultures which include both smokers and nonsmokers. Creating a healthy environment to cater for this diversity is challenging for some employers especially when the preference of one group affects the other such as smokers and non-smokers. However, management has the responsibility to create a healthy workplace environment by enforcing the polices that ensures a safe environment for everyone.
Change of tobacco-free workplace has increased the implementation of health policies prohibiting the use of tobacco products in and around healthcare organizations. Many of the healthcare organizations seek to promote a clean and healthy image to the public and have recognized the adoption of the tobacco-free hospital policy as a way to show off this health commitment. Hospitals have adopted policies banning tobacco use in the workplace over the last few years and has become a nationwide trend. Various kinds of resources are developed and initiated in healthcare facilities to assist in implementing the tobacco-free policies. The organizations are responsible for maintaining and enforcing these policies to ensure a clean environment and protect the health of their patients and employees.
Policy Analysis
The tobacco-free policy aims at preventing the use of tobacco by employees and patrons within the area of a healthcare organization (Kim, 2009). An organization that implements this policy wants to present a clean environment to the public who are the primary beneficiaries of its services.
Several strategies are implemented to ensure the transition of the policy is smooth and effective for all. The policy is an initiative for improving health by incorporating it into the wellness planning of employees to prevent those who smoke from feeling targeted. Collaborating with the community around the healthcare organization is essential to bolstering the policy. A team is formed to enforce the policy in the organization. Penalties are implemented for people caught violating the policy which may include removing them from the premises or firing employees.
The tobacco-free policy must be reviewed and modified if necessary due to the implementation of new legislation. The policy can range simple restrictions to a complete ban on smoking. When the policies were first put into place, it involved creating segregated areas in the workplace for smokers and non-smokers. The tobacco was not eliminated and could still affect the non-smokers though minimally.
To create a smoke-free environment, the policy can prevent smoking in the premises of the facility but allow smoking in designated areas outdoors. The policy can also allow a designated area for smoking which is well ventilated.
The policy reduces tobacco smoke in the environment by controlling the source of the smoke. The policy should involve employees because their support is important for the implementation of the policy to be successful. Before the policy is implemented, the discussion takes place among the employees and the management to clarify any issues and define transition steps for the policy. Once the discussion has taken place, the organization can implement the policy and keep the employees informed on every stage of the policy transition. After the transition is completed, the smoking ban can be enforced in the organization. After implementing the policy, it is important for the organization to ensure that no one is given privilege among smokers despite their position in the company in order to prevent resentment or disputes.
Issues addressed by the Policy
Smoking is a major health problem that has impacts on the health of the smokers and non-smokers especially in healthcare professionals and patients. It is the responsibility of healthcare organizations to provide a safe and clean environment for everyone in the facility.
The policy addresses the issue of the healthy environment in and around healthcare organizations. Tobacco smoke creates an unhealthy environment for providing health services. It affects the health workers and patients whose conditions such as asthma may be aggravated by the smoke (Bloor, 2006).
The policy addresses safety issues within the organization. Research indicates that a significant number of fires in the workplace are started by discarded cigarettes. This costs an organization a lot of money due to property damage or loss of life. It is expected that maintenance expenses incurred due to smoke in the environment will also be reduced.
The policy seeks to increase the morale of employees especially non-smokers affected by the environment. It also aims to address legal costs incurred by an organization when it is sued over the smoky environment that affects the employees.
History of the legislation
There are state laws that regulate smoking in the workplace. These laws were established after research indicated that exposure to second hand tobacco smoke is extremely detrimental. The aim of the legislation to protect the health of employees. Employees with health conditions that can be affected by smoking are protected under the American with Disabilities Act enacted in 1990. Employers are prohibited by the Act from discriminating against employees with disabilities. In a situation where tobacco smoke is involved, employees can request for a smoke-free workplace.
Effectiveness of the legislation in addressing the issues
The tobacco-free policy has changed the organizations where it has been implemented. It mostly covers indoor setting of organizations although it is sometimes applied to outdoor as well. When the policy is enacted in healthcare organizations, the health and safety of the patients, employees and the community are protected from contact with tobacco smoke. The policy reduces exposure of second-hand which can affect their health. It creates a safe and healthy environment in the workplace where healthcare professionals can work well without interference from smoke (Juster, 2007).
The policy supports local groups in the community who use or visit the healthcare organization to promote healthy lifestyles and spread awareness of the tobacco-free campaign. With the policy in place, cigarette litter common with smokers is reduced which eliminates the chances of it being ingested by children or pets. Maintenance costs in the organizations are reduced as cigarette litter and smoke are removed from facilities and creates longevity of equipment such as furniture.
Tobacco-free policy reduces the risk of fires in the organization which are mainly caused by matches or cigarette litter increasing safety for the people within the organization. By promoting a smoke-free environment, employees who are smokers are encouraged to quit smoking and adds support for those who are trying to quit or have recently quit.
Smoke-free workplaces not only reduce health issues from the tobacco smoke but improve the productivity of the workers (Farzadfar et al., 2013). Smoke filled environments reduce productivity in the workplace due to absences of employees with smoke-related illnesses. Loss of productivity in an organization is also contributed by smoke breaks taken by employees. Non-workers have to work harder to compensate for this work gap caused by the incompetence of the smokers. The policy assists in increasing productivity at the workplace by preventing smoke breaks and reducing disputes in the workplaces that may occur between smokers and non-smokers over unbalanced work load.
Studies show that a majority of workers both smokers and non-smokers prefer working in a smoke-free environment. The tobacco-free policy promotes a smoke-free and safe environment conducive for the employees. This environment protects the health of employees and there is an improvement in the morale and the overall job performance.
An organization with a tobacco-free policy in place eliminates legal costs that can occur due to patients or employees suing the organization over smoke in the environment which reduces direct healthcare expenses incurred. The employees may negotiate for a lower health, life and disability coverage as tobacco use is cut in the organizations.
A strong clear policy that includes penalties for violations relieves management from the responsibility of enforcing tobacco use on the premises on their own. It creates a positive image of healthcare to the public by showing that the organization cares about the health of their employees and patients.
People most affected by the problem
Smoking affects various people, smokers and non-smokers alike. Smokers are directly affected by tobacco use as it affects their health which makes them likely to get ill resulting in taking more time off. Smoking can cause lung cancer, heart disease and respiratory illnesses in smokers (US Department of Health and Human Services, 2014).
Non-smokers are mainly affected by second-hand smoke especially those who live or work with smokers. Second-hand smoke has a combination of smoke from the cigarette and the breath of the smoker. Research has indicated that second-hand smoke results in the death of thousands of non-smokers and might play a role in the development of lung cancer (Chambrone et al., 2013)
Children are the most vulnerable group of non-smokers. Children who live in homes where they are regularly exposed to secondhand smoke are likely to suffer respiratory illnesses and other infections at a higher rate. The second-hand smoke is known to worsen asthma attacks resulting in bronchitis or pneumonia and increase the rate of ear infections in children.
Secondhand smoke also affects pregnant women and the fetuses. Pregnant women exposed to the second-hand smoke are more likely to have miscarriages or stillbirths or babies born with impaired lungs.
Patients exposed to second-hand smoke in healthcare environments have a high risk of suffering from respiratory diseases. The smoke may worsen health conditions in patients with respiratory illnesses such as asthma and bronchitis which can result in the death of patients (Jha & Peto, 2014).
Future of this legislation
Adoption of tobacco-free policy in various industries is set to continue as people look for safer environments where they can live and work. Recent proposals involve implementing this policy for multi-unit housing where landlords and tenants suffer health consequences from smoke that drifts into their unit from units occupied by smokers. Smoke-free apartments have been proposed to protect the health of all the stakeholders.
WHO and other health organizations have called for more measures to be put in place to protect non-smokers against exposure to second-hand tobacco smoke. Many countries have participated in the discussion of initiatives that seek to promote smoke-free places where everyone can benefit. These efforts are expected to inspire policy makers and employers to enact tobacco-free policies that will create workspaces that are free from the smoke with the aim of increasing productivity, reduce smoke-related illnesses.
Increasing awareness campaigns from organizations and communities around the world on the consequences of tobacco smoke are expected to increase the number of organizations and employers implementing a tobacco-free policy to make workplaces smoke-free.
References
Bloor, R. N., Meeson, L., & Crome, I. B. (2006, April). The effects of a non-smoking policy on nursing staff smoking behavior and attitudes in a psychiatric hospital. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16608474
Chambrone, L., Preshaw, P. M., Rosa, E. F., Heasman, P. A., Romito, G. A., Pannuti, C. M., & Tu, Y. K. (2013, June). Effects of smoking cessation on the outcomes of non-surgical periodontal therapy: A systematic review and individual patient data meta-analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23590649
Dennis, B. (2015, November 12). Who still smokes in the United States – in seven simple charts. Retrieved from https://www.washingtonpost.com/news/to-your-health/wp/2015/11/12/smoking-among-u-s-adults-has-fallen-to-historic-lows-these-7-charts-show-who-still-lights-up-the-most/?noredirect=on&utm_term=.2dee65cd3583
F., G., H., J., J., A., . . . M. (2011, October 11). National and subnational mortality effects of metabolic risk factors and smoking in Iran: A comparative risk assessment. Retrieved from https://pophealthmetrics.biomedcentral.com/articles/10.1186/1478-7954-9-55
Jha, P., & Peto, R. (2014, January 02). Global effects of smoking, of quitting, and of taxing tobacco. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24382066
Juster, H. R., Loomis, B. R., Hinman, T. M., Farrelly, M. C., Hyland, A., Bauer, U. E., & Birkhead, G. S. (2007, November). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040364/
Kim, B. (2009, September). Workplace smoking ban policy and smoking behavior. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19806001
http://www.who.int/tobacco/en/atlas38.pdf
US Department of Health and Human Services. (2014). The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health,17.
