Electronic Cigarettes on Hospital Campuses

Abstract

Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121) to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62%) completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.

Keywords: electronic cigarettes; smoke-free policy; tobacco products.

Figure 1

NC hospital campus tobacco policies (n = 75).

Figure 2

Use of tobacco products currently a problem on the hospital campus (n = 75). * Significantly different compared to staff (p < 0.01) and patients (p = 0.02).

Figure 3

Barriers experienced when developing a policy regulating the use of e-cigarettes (n = 60). * Other includes concerns that enforcing e-cigarette policy would be too difficult (3%); legal concerns (3%); and cost of implementation (2%).

Figure 4

E-cigarette policy communication methods (n = 58). * Other includes communication through staff meetings and policy revision updates.