Smoking epidemiology in smoke-free hospitals

1. Smoking epidemiology in smoke-free hospitals Numerous data exists showing that in most European countries, health-care workers smoke less than the general population, but in many situationsthey are heavy smokers.

2. Tobacco Consumption in Europe15 years and older 37% 21% Germany 27% 42% Austria 31% 19% Belgium 37% 37% Denmark 27% 45% Spain 27% 19% Finland 27% 40% France Greece 46% 28% Ireland 28% 29% Italy 38% 26% Luxembourg 32% 26% Netherlands 36% 29% Portugal 38% 15% U.Kingdom 28% 26% Sweden 24% 22% Males Females From: U.E. OMS March 1996

3. Smoking: Attributable mortality 1/5 of all deaths in all ages. 1/4 of all deaths in people aged between 35 – 64 years Smokers aged between 35–69 years who die from a tobacco related illness, lose around 22 years of their life expectancy.

4. Tobacco attributable mortality in EU (1955 – 1995) /1 000 442 423 423 392 324 Males Females 184 89 97 76 47 28 10 1955 1965 1995 1975 1985 1990 From : Peto, Lopez 1992, 1994

5. Tobacco attributable mortality in developed countries (1950 – 2000) 50 45 40 Male 35 30 Accumulated millions 25 of deaths 20 15 Female 10 5 0 1950 1960 1970 1980 1990 2000 From : Peto et all Oxford University Press 1992, A22

6. Smoking habit of Bispebierg Hospital in Denmark. 33% 32% Complaint for passive smoking = 25% Smoking Females Smoking Males Olsen AD et al. Active and passive smoking among hospital staff at the Bispebjerg hospital 1992-1999. Ugeskrift for Laeger. 162(42):5623-7,2000 Oct 16.

7. Smoking habits of HCW in Italian hospitals 44% 39% HCW smokers Physician smokers Nardini S. et al. Personal smoking habit and attitude toward smoking among the health staff of a general hospital. Monaldi Archives for Chest Disease. 53(1):74-8,1998

8. Smoking habits of Spanish nurses 53% • Fernandez Ruiz ML, Sanchez Bayle M. Prevalence of smoking by women physicians and nurses in the community of Madrid. Revista Espanola de Salud Publica. 73(3):355-64,1999 47% Smoking nurses No smoking nurses

9. Smoking habit of hospital HCW in France • Grizeau D et al. Attitudes et comportement du personnel hospitalier face au tabagisme. Revue des maladies respiratoire 1998,15,79-87. 31,2% 36,8% Smoking habits among HCW in France 32,6% Smokers females Smokers males

10. Smoking habits of midwifes and student nurses (IFSI) in AP-HP in France. 100% 80% 60% 40% 20% 0% Midwife IFSI Feb 2000 IFSI Oct 2000 Regular smoker Ex- smoker Occasional smoker Non- smoker

11. Survey of smoking habits of HCW in European hospitals • The ENSH proposes to include 13 standard questions in a survey of all health care workers, to be able to compare differences in European countries. • 2 page questionnaire is also available.

12. 13 questions on smoking habits of HCW • age <20 21-25  26-30  31-35 36-40  41-45 46-50  51-55 56-60  >60ans • Sex malefemale • Your job:  Technical Administrative Physician Nurse others • Are you at the management level: yes no • Did you work :  at fix hours  at various hours  never the night,  sometime the night  always the night • Have you smoke some cigarettes in your life ? yesno • Presently are you : no-smoker ?  former smoker ? smoker ? (since> 1 month) (at least 1/day) • SMOKERS • On average, how many cigarettes do you smoke a day ? • <1  1 2-3 4-5  6-9 10-13  14-19  20-24 • 25-29 30-34 35-40 41-60 >60 • How long after waking up do you smoke your first cigarette? • < 5 minutes 6-30 minutes 31-60 minutes > 60 minutes • Do you plan to stop to smoke :  •  In the next 3 months in the 6 months  within the year  not at this time  no • Smoke in your environment • smoker ex-smoker non-smoker • Your company is:    • Your nearest colleague is:    • Your nearest friend is:   

13. 22 questions on your opinion on tobacco in hospital • Smoking room exist in the hospital ?  yes  no • Nobody smoke in the hospital (except in smoking room)  yes  no • Conflict exist between smokers and non-smokers  yes  no • Protection of non-smoker had to be reinforce ? yes  no • Smoking room had to be better (more) managed ?  yes  no • I am regularly disturbed by the tobacco smoke of the others  ?  yes  no • Hospital will be better take in account smoker problems ?  yes  no • Is you colleagues encourage you to be a non-smoker ?  yes  no • Which activity encourages you to smoke • Meeting  yes  no • Discussion  yes  no • Coffee break  yes  no Treatment  yes  no • During the night  yes  no • Meals  yes  no • Are you disturbed by the tobacco smoke of others •  very often  often  sometime  never • Have you ever complained about tobacco smoke:  • In your work place  very often  often  sometime  never • In your hospital  very often  often  sometime  never • In other public places  very often  often  sometime  never • Do you think that trying to convince others to quit tobacco is part of your job ?  ? • yes, certainly yes, in some case no • As a HCW, do you think you have an exemplary role for patients  yes  no • In your activity sector is there : • A staff smoking room  yes  no •  A non-smokers staff room  yes  no