No Smoking Policy in HHS Seniors facility
Exposure to tobacco smoke either direct or second-hand cause adverse health outcomes such as asthma, respiratory illnesses, cardiovascular disease, and cancer (CDC, 2012). According to the National Institute of Health (NIH) smoking is a leading cause of cancer and death from cancer (2011). There are about 250 known harmful chemicals in tobacco smoke and about 69 are known cancer-causing chemicals (NIH, 2011). Cigarette smoking causes one in five deaths in United States and more than 480,000 deaths each year in the United States inclusive of deaths from second- hand smoke (CDC, 2014). The U.S. Department of Housing and Urban Development (USDHUD) encourages adoption of a no smoking policy which must comply with all applicable fair housing and civil rights requirements (2012). According to USDHUD, a facility may choose to develop a policy to prohibit smoking in all common areas or policies to create a totally smoke-free property (2012). The American Lungs Association states that Smoke free multi-unit housing policies are beneficial for both residents and property owner (2012). Therefore, it is important to eliminating indoor smoking as a means to protect nonsmokers from the harmful effects of tobacco smoke.
The management of HHS facility desire to reduce resident’s exposure to the effects of secondhand smoke, reduces maintenance, cleaning and redecorating costs from smoking and reduce the risk of fire as a result of smoking in building. The adaptation of a smoke free policy can act as a catalyst for HHS residents to quit smoking. A no smoking policy will make a building safer and even qualify a property for lower insurance rates. According to American Lungs Association (ALA), implementing a smoke free policy is not just healthy; it promotes green living (2012). Using the ethics of the good, implementation of a no smoking policy has several benefits to the employees at HHS facility, it increases productivity, protect and promote good health for everyone. Also, it reduce the organization’s risk of legal action regarding exposure to tobacco smoke at work by care givers and other employees at HHS facilities.
- Development of the Policy
According to Deveterre, institutional policies should be developed by the ethics committee of the organization (e.g. Hospital ethics committee) and endorsed by the medical staffs and administration (2010). The first step in writing a smoke free policy is deciding on what the policy will include. The policy will restrict residents, guest, staffs and every one at HHS facility from smoking in the building and within 20 feet’s of the environment. The policy will incorporate the whole property including individual units and common areas. The success of this policy will depend on forming good relationships with various stakeholders such as residents, family members and staffs of HHS facility. We will target educational efforts to inform everyone on the hazard of smoking and effect of second hand smoking on the health status.
- Communicate the policy
It is necessary to inform everyone especially residents and employee of the smoke free policy. Also, it is important to inform the residents of what the policy covers, reasons for the policy (e.g. reducing fire risks, improving health and protecting property of the residents). It is important for the management to advertise HHS facility as a smoke free environment and ensure strict enforcement. All employees will be informed of the no smoking policy and the consequences that will result when they are not adhered to. During orientation, new hires will be informed of the smoke free policy to ensure that they are specifically aware of the expected standards. It is also necessary to educate visitors and family members on the health effects of smoking and secondhand smoke to prevent breaking of the law.
- Implementation of the policy
The policy will be implemented when resident sign agreements to live and receive care HHS facility. Also, new hires and employee will be required to sign a written agreement not to smoke within 20 feet of the facility and during the work shift. The case managers will ensure residents read and understand the policy and obtain approval to show understanding of the policy.
- Enforcement the policy
To enforce the no smoking policy, HHS facility will post signs to remind the residents and guests of the no smoking policy. The management will act quickly when there is report of violation of the policy. Also, we will make residents liable for all smoking related damages.
Evaluation of the smoke free policy:
In assessing the success of the smoke-free policy, HHS facility personnel will collect data on the expected outcomes of the policy and its effectiveness in reducing exposure to secondhand smoke. Although long-term health outcomes, such as reduced incidence of tobacco-related disease among nonsmokers are hard to attribute to any one intervention, a few measurable indicators that might demonstrate success can be determined. For example, we will ask residents the following questions:
- What changes have occurred in the percentage of nonsmokers reporting exposure to secondhand smoke?
- What improvements have occurred in air quality (e.g., levels of particulate matter) in common areas, individual rooms and outside the building?
- Legal Requirement
Since HHS facility will be changing its policy and prohibiting smoking, they will allow current residents who smoke to continue smoking in areas that are designated strictly for smoking. During favorable weather condition, this will be an outside area within 20 feet away from the facility. Residents admitted after the facility changes its policy must be informed of this policy at admission. Also, the Older Americans Act does not require nursing homes to allow smoking to satisfy resident choice requirements.
Healthcare professionals especially public health department are an important component of almost every smoke free air campaign. In order to implement this policy, HHS facility management will inform the state department of public health and state department of building regulation that the facility will be implementing a smoke free policy. According to Illinois smoking regulation, no person is allowed to smoke in a public place or in any place of employment or within 20 feet of the entrance.
The smoking policy of HHS facility will be adopted from the Sonoma State University smoking policy which became effective on January 27th, 2003. It is the policy of HHS facility to prohibit smoking within the facility and other areas of the facility where non-smokers can avoid exposure to tobacco smoke. Smoking is prohibited in all buildings, work areas, relaxation spots, reception areas, meeting rooms, lobbies, hallways, stairwells, elevators, eating areas, lounges, and restrooms, and within twenty (20) feet within the facility. Smoking is also prohibited in vehicles owned by the HHS facility. Smoking will be permitted in outside areas past twenty (20) feet of HHS facility except at decks and patios associated with the facility. Lighted tobacco products must be smothered, and tobacco residue must be retained in an appropriate ash trays or other waste vessel located outside of non-smoking areas. The sale and distribution of tobacco products is prohibited within HHS facility.
American Lungs Association. (2012). Smoke free multi-unit housing. Retrieved April 9, 2014, from http://www.lung.org/assets/documents/healthy-air/smuh-policy-brief-update.pdf
Centers for Disease Control and Prevention. (2012, June). Smoking and Tobacco Use. Retrieved April 9, 2014, from http://www.cdc.gov/tobacco/basic_information/health_effects/index.htm
Centers for Disease Control and Prevention. (2014, February). Smoking and Tobacco Use. Retrieved April 9, 2014, from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/index.htm
Devettere, R.J. (2010) Practical Decision Making in Health Care Ethics: Cases and Concepts,
Washington D.C.: Georgetown University Press, Third Edition
National Institutes of Health. (2011, January). Harms of Smoking and Health Benefits of Quitting. Retrieved April 9, 2014, from http://www.cancer.gov/cancertopics/factsheet/Tobacco/cessation
Sonoma State University. (2003, January). Smoking Policy. Retrieved April 9, 2014, from https://www.sonoma.edu/uaffairs/policies/smokingpolicy.htm
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. (2012, October). Further Encouragement for Owners and Managers to Adopt Optional Smoke-Free Housing Policies . Retrieved April 9, 2014, from http://portal.hud.gov/hudportal/documents/huddoc?id=12-22hsgn.pdf
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