The study aimed to identify the extent of smoking, compliance with tobacco restrictions, and attitudes toward smoking and tobacco control measures among the employees in a Comprehensive Cancer Center from 2001 to 2006 where a smoke-free policy was progressively introduced. Four cross-sectional surveys were conducted from 2001 to 2006. Survey items include smoking status, smoking history, environmental tobacco exposure, and agreement with tobacco initiatives. The prevalence of smoking has declined from 34.5% in 2001 to 30.6% in 2006. The decrease was present in all professional groups: Doctors from 20.0% in 2001 to 15.2% in 2006 and administrative clerks from 56.0% in 2001 to 37.0% in 2006 reduced the most. Among nurses, the prevalence of smoking was still high with a 2-point percent reduction (from 34.0% in 2004 to 32.6% in 2006). Other changes of the pattern of smoking were apparent: a reduction on the number of cigarettes smoked, decrease of daily smokers, and increase of smoking abstinence during the hospital duty. Compliance with smoke-free areas increased. We observed a very significant decrease of the perception of exposure to environmental tobacco exposure at work. The Smoke Free project helped to achieve a healthy work environment. Tailored smoking cessation programs should be designed to help healthcare professionals to stop smoking. In addition, healthcare professionals should play a key role in promoting a healthy smoke-free lifestyle.

The objective of the study was to describe the implementation of measures for preventing tobacco consumption developed in the Catalan Network of Smoke-free Hospitals. Information from 25 hospitals that are actively involved in the Catalan Network of Smoke-free Hospitals (April 2004) was used. The degree of implementation of the Smoke-free Hospitals Project was analysed by means of the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals; each hospital was analysed globally and according to the duration of its Network membership (<1 year: implementation stage; > or =1 year: consolidation stage). In terms of global indicators, there were high levels of commitment (64.8%), communication (74.7%), tobacco control (77.4%) and implementation of smoke-free environments (81.0%). A lower degree of implementation (<50%) was found in education and training, health promotion and healthy workplaces. According to the duration of Network membership, significant differences were observed for communication, environment, healthy workplaces and follow-up. Deficits were observed in areas such as specialist training and cessation support, and further input is required here. By identifying areas needing attention, providing a guide for policy development and by administering it periodically, one can ensure that progress is kept on track.

Object of the study was to assess educative needs in the field of drug therapy among 99 chronic patients with advanced chronic lung disease admitted to the Respiratory Service of the Hospital Sta. Creu i Sant Pau (Barcelona, Spain). The knowledge of the patients about their previous drug treatment, sources of information as well as patients' conception of side-effects, was gathered from medical records and by means of a questionnaire. The majority of patients studied were male (63%), aged over 60 years (average 63 +/- 12), illiterate or with basic education (88%), had a chronic obstructive, pulmonary disease (76%) and with an important degree of chronicity. They had been treated for their condition during a mean of 8.4 years and took an average of 4.6 drugs. 31% Of patients did not answer any question about their medication properly and only 17% gave a correct answer to all the questions. The lower the age and the higher the educational level, the higher the proportion of correct answers to knowledge questions. 35% Of the patients stated not to have been informed about their medication and 55% stated that they had read the patient package inserts.

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The Catalan Network of Smoke-Free Hospitals was created by the Catalan Institute of Oncology in 2000. Currently (December 2003), 45 of the 66 hospitals of the Public Health System in Catalonia are members of this network. Organization through a network promotes and strengthens the exchange of experiences in real time. It provides mutual support in education, training and evaluation and enables common continuing training. Such an initiative, based on consensual work through a network, facilitates progress in tobacco control.

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