Making Hospitals in China Smoke-Free: A Prospective Study of Implementing the New Standard

Abstract

The smoke-free standard is feasible even in a country with a widespread acceptance of smoking inside health facilities. Several challenges need to be addressed when the new standard is disseminated across China.

Signs, Fines and Compliance Officers: A Systematic Review of Strategies for Enforcing Smoke-Free Policy

“…Violation penalties and/or enforcement officers . Ten studies [ 12 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ] described the use of penalties for violations and/or the role of enforcement officers. Compliance inspections on restaurants in New York City were integrated into existing routine health department checks, and clear monetary penalties were set for violations for both owner/managers and smokers.…”

“…In the pharmacy setting, staff were responsible for policy enforcement by asking violators to stop smoking or leave the premises [ 24 ]. In Chinese hospitals, financial incentives were used for wards that were declared smoke-free, while disincentives were used when there was smoking inside hospitals, although the authors do not describe what constitutes a disincentive [ 29 ].…”

“…Of the ten papers which included penalties and/or enforcement officers, two included enforcement officers as part of the strategy implemented in the study [ 12 , 24 ]. One paper collected data from 2003–2006 [ 12 ], with the others being cross-sectional surveys [ 24 , 25 , 26 , 30 , 31 , 32 ] or pre-post data collection after the intervention [ 29 ]. Eight of the studies found some level of compliance, with reported rates ranging from 39% [ 27 ] to 84% [ 25 ].…”

“…Eight of the studies found some level of compliance, with reported rates ranging from 39% [ 27 ] to 84% [ 25 ]. Five suggested that the strategy was associated with successful compliance [ 12 , 26 , 27 , 29 , 32 ]. Interestingly, two studies with similar compliance rates interpreted the results in opposition.…”

“…System change involves the change of practices and/or procedure in the workplace. Four studies [ 16 , 17 , 27 , 29 ] covered the use of system changes such as recording smoking status, staff education and training, and cessation support to aid policy enforcement. In psychiatric services in Spain, recording client smoking status was one of the most commonly used strategies involved in becoming smoke-free [ 16 ].…”