Hospital workers smoking – only the most addicted flout the rules

A survey of staff at Addenbrooke's hospital has shown that those who break the smoke-free policy are generally more addicted than those who respect it. Researchers writing in the open access journal BMC Public Health also investigated staff's attitude to the smoke-free policy and found that smokers were less likely to believe that the policy would protect people from second hand smoke.

With funding from the Addenbrooke's Charitable Trust, Tom Parks was one of a team of four medical students from the University of Cambridge School of Clinical Medicine (UK), based at Addenbrooke's, who carried out the survey. He said, "We found that those who smoke in contravention to the smoke-free policy do so neither for pleasure nor to avoid feeling low; instead it is a resistant habit, which has little or no influence on the smoker's mood, and is determined in part by chemical dependence".

All 6,981 members of staff at the hospital were given the opportunity to take part in the anonymous survey, and 704 completed and returned the questionnaires. Among the 101 smokers, 69 were compliant with the hospital's smoke-free policy while 32 were non-compliant. Gender, age and ethnicity were similar between compliant and non-compliant smokers. Contract ancillary workers were less likely to comply, while clerical and managerial staff were more likely to comply.

Importantly the results showed for the first time that the non-compliant smokers were also the most nicotine dependent and smoked most out of habit. According to Parks, "Habitual smoking is a form of psychological addiction, which may coexist with chemical dependence, where there is no true reason for smoking except that it has become learned and automatic, with no influence on the smoker's mood or affect. For example, the smoker may not even be aware of smoking and may even light one cigarette while another is still burning in an ashtray".

Parks and his colleagues hope that their research will inform future NHS smoking policy. They write, "There may be merit in screening the working population for individuals with the particular smoking behaviours we identified and offering them evidence-based workplace interventions for smoking cessation. This might not only improve their compliance but also, more importantly, increase the likelihood that they quit smoking".

Full bibliographic information: Failure of hospital employees to comply with smoke-free policy is associated with nicotine dependence and motives for smoking: a descriptive cross-sectional study at a teaching hospital in the United Kingdom
Tom Parks, Clare VR Wilson, Kenrick Turner and Joel WE Chin
BMC Public Health (in press)