SMOKING BANS IN US HOSPITALS - RESULTS OF A NATIONAL SURVEY

Objective.-To examine compliance and characteristics of hospitals with tobacco control standards enacted by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Design and Setting.-On-site national survey of hospitals as part of routine JCAHO accreditation visits. Participants.-A total of 3327 US hospitals received site visits in 1992 and 1993 and were matched with American Hospital Association Annual Survey of Hospitals data. Main Outcome Measures.-Compliance or noncompliance with tobacco control standards; location in a tobacco-producing state, and organizational characteristics, including provision of psychiatric/alcohol-chemical dependency services. Results.-Two years after implementation, 95.6% of hospitals met the new JCAHO smoking ban standard; 90.9% of hospitals were in compliance with a second smoking standard requiring development and use of medical criteria for physician-ordered exceptions to the ban. Hospitals in tobacco-producing states had higher-than-average rates of compliance when compared with hospitals in other states. Hospitals providing psychiatric and/or substance abuse services had lower-than-average rates of compliance. Conclusion.-This first industry-wide smoking ban has been successful. However, hospitals should consider evaluating the use of medical exceptions to this policy.