Sunday, March 17, 2013

Smoking Policy: Hospice–Palliative Care, Other Patients in Healthcare Facilities (Video 3:33)

Should hospice-palliative care or other patients be exempt from statewide smoking bans?  When I wrote a few years ago about the smoking problems I experienced as a hospice volunteer in nursing homes, I was told that was “a touchy subject.” All the nursing homes where I volunteered had “restricted” indoor smoking areas to accommodate patients and staff who wanted to smoke. I held my breath to avoid second-hand smoke every time I briefly entered a smoking room to get a chair when they were not available in the halls. Smoke, which was both seen in the air and smelled, floated into the halls every time the doors to smoking rooms opened. Whether they smoked or not, everybody’s nostrils were assaulted with sucker punches of first or second-hand smoke.

In the United States, tobacco use remains the single largest preventable cause of disease and premature death. It accounts for billions of dollars in healthcare expenditures and productivity losses. According to Wikipedia, smoking bans in the United States are entirely a product of state and local criminal and occupational safety and health laws. In 1995, California was the first state to enact a statewide smoking ban. More states have followed. Laws often have certain exemptions.

Because hospice-palliative care focuses on meeting patients’ psychological, physical and social needs, a smoke-free policy can be a serious concern. Many feel that terminally ill patients who smoke should be allowed to continue in order to have “quality of life,” particularly when their lives are already so limited. Several of my hospice patients who were only supposed to smoke in restricted areas had oxygen tanks stationed near their beds. Others say smoking has no place in a healthcare institution and that these institutions should all follow statewide legislation.
Should hospice-palliative care or other patients be exempt from statewide smoking bans? What do you think?

This video presents challenges of a smoke-free hospital in England where all hospitals have been designated as smoke-free sites. George Eliot Hospital also offers nicotine replacement therapy as an alternative for helping people, including visitors, quit smoking.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at booksellers such as Amazon and Barnes and Noble .