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Mindfully.org
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Health risks, the rising costs of cigarettes, and even his daughter's pleas haven't stopped Roger Galimba from smoking for 27 years.
But when Galimba's employer, Group Health Cooperative, announced its campuses would go smoke-free by Jan. 1, he had one thought: It's time to quit.
Galimba, a painter for Group Health, shivered against the chill last week as he lit up one of his last cigarettes in the smoking corridor of the Redmond campus. Doctors and nurses in surgical scrubs took quick drags before heading back inside.
"It will be good if I don't have a place to smoke at work," Galimba said. "You come here and you see other people smoking ... it's tough."
Nationwide, hospitals are snuffing out tobacco on their campuses, spurred in part by state and local laws restricting the habit. Half of King County's major hospitals have joined the movement. Swedish Medical Center, the state's largest health-care provider, went smoke-free two weeks ago. Valley Medical Center in Renton did so in March.
Virginia Mason Medical Center in Seattle was one of the first to ban smoking entirely, acting in 1994.
While some hospitals remain skeptical, others call it an overdue cultural shift.
"Hospitals have been reluctant to tell people how to run their personal lives," said Rick Wade, senior vice president of the American Hospital Association. "But with smoking, your personal behavior does have a detrimental effect on the others around you — not just yourself."
Not all hospitals are convinced the ban is practical or even fair.
"It's a constant balance to meet the needs of everybody," said Susan Gregg-Hanson, spokeswoman for Harborview Medical Center. "The families and patients that come in here are so traumatized ... in that crisis time, a smoke might help them focus and get through it."
Harborview, a level-one trauma center, has no plans to eliminate the few designated outdoor smoking areas on its downtown Seattle campus, Gregg-Hanson said.
The campuswide bans go beyond Initiative 901, a state law that took effect this year and prohibits smoking inside a public facility or within 25 feet of any entrance to a public building.
To ease the transition, providers like Swedish and Group Health are offering staff and patients smoking-cessation programs and free nicotine-replacement therapy.
"We want to be the role models for the behaviors we are talking to our members about," said Suzanne Swadener, project manager for Group Health. "Doing the right thing means you practice what you preach."
The changes represent a dramatic turnaround from years past.
A popular ad from the 1940s shows a gray-haired man with a stethoscope around his neck, a cigarette dangling between his fingers. The slogan reads: "More doctors smoke Camels than any other cigarette!"
Patients once used to be able to light up in their rooms. Even 15 years ago, hospitals cordoned off areas inside buildings to accommodate smokers.
But going smoke-free — and enforcing the new policy — poses challenges for many hospitals.
At Overlake Hospital Medical Center in Bellevue, the designated smoking area is a locked courtyard between the east and west corridor of the hospital. Patients must be accompanied by staff to go out there to smoke. Staff are usually found smoking near the ambulance drop-off.
"We have one foot in advocating for health and one foot in accommodating the community," Overlake spokeswoman Alison Estep said. "It will continue to be an issue for us."
Posted signs at Swedish and Group Health will alert people to the new policy. But hospital officials acknowledge enforcement remains an ongoing struggle. None impose penalties for smoking.
"We've tried to emphasize that we won't be seen as the smoking police," said Marianne Klaas, director of accreditation and safety for Swedish. "We know that this is just the beginning. It's going to take a lot of reinforcement."
To help with that, Swedish has come up with a script to approach smokers:
"Excuse me, but smoking is not allowed on Swedish property. You may smoke on a public sidewalk as long as you're at least 25 feet from doors, open windows or air vents."
At Group Health's Redmond campus, Galimba and other smokers wearing employee badges puffed in a hurry. Some had just a few minutes between shifts. Six ashtrays lined the outdoor corridor and a cloud of smoke hovered above.
Julie Christensen, a Group Health nurse, said she was less than thrilled about the new policy.
"I think it's kind of ridiculous, seeing as how it's a legal drug," she said. "This is our social hour."
Sonny Huynh, of housekeeping, agreed. "It's our personal choice. It feels like we're being treated like criminals or something."
Galimba said he hopes the new policy will be his turning point.
"My daughter said, 'Daddy, if you love me, you'll quit,' " he said. "So maybe this is it. I'm going to call the doctor to get a patch."
source: http://seattletimes.nwsource.com/html/localnews/2003458047_smoking02e.html 2dec2006
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