Hospitals ban butts

Campus-wide prohibitions set to take effect Thursday

Cigarette smoking is the leading preventable cause of death in the United States, where it is responsible for about 438,000 deaths annually, according to the U.S. Centers for Disease Control and Prevention. Some 38,000 die because of secondhand smoke exposure, the agency says.

Cigarette smoking costs more than $167 billion in lost employee productivity and medical expenses, according to the center. Health care costs related to secondhand smoke run about $10 billion annually.

In Maryland, the costs of medical conditions proven to be caused by exposure to secondhand smoke — which include lung cancer, heart attacks, sudden infant death syndrome and asthma — were $597.6 million in 2005, according to a study by the Johns Hopkins Bloomberg School of Public Health. Some 1,577 adults and 24 children died in 2005 because of passive smoking in Maryland, the study says. The total did not include costs for outpatient treatment, prescription drugs and lost work productivity.

With hospitals being places where patients are often ill or recovering from injuries, it makes sense to limit their exposure to smoke, executives said. Thus, they are asking employees not to smoke even off campus during their workdays.

‘‘If an employee comes in smelling like smoke, that could affect a patient’s asthma or some other problem,” said Judy Lichty, regional director of health and wellness for Adventist HealthCare of Rockville. The system includes Shady Grove Adventist in Rockville and Washington Adventist in Takoma Park.

It’s also important to try to improve the health of employees, which can have a bottom-line impact in reduced health care costs and not having to pay for tobacco products, she said. Gov. Martin O’Malley (D) has proposed doubling the state cigarette tax to $2 a pack to raise funds for health care costs and to help plug a budget deficit. A Senate committee approved that increase this week; the proposal still requires approval by the full Senate and House.

‘‘We have programs to help employees quit,” Lichty said. ‘‘They can get counseling free and nicotine-replacement therapy free. But we’re not telling our employees that they have to quit.”

From 11 percent to 15 percent of Adventist HealthCare employees smoke, Lichty estimated. That is below the national average for adults of 21 percent, according to the CDC. The ban also covers Adventists’ other facilities, including nursing homes.

From 10 percent to 20 percent of Frederick Memorial Hospital’s roughly 2,400 employees may use tobacco, spokesman Harry Grandinett estimated.

‘‘We have had 170 go through our free cessation programs,” Grandinett said.

Suburban Hospital in Bethesda will cover the costs of employees’ smoking-cessation drugs for the first six months, spokeswoman Ronna Borenstein-Levy said. The hospital is offering staff members counseling, nicotine patches and other aid, she said.

‘‘For many of our staff this is a challenge,” Borenstein-Levy said. ‘‘But there are many looking forward to it, because it has been difficult for them to quit in the past.”

Banning together

The ban, which applies to all patients, visitors and employees, was coordinated by the hospitals to fall on the same day as the Great American Smokeout. That nationwide observance is held annually to raise awareness of the dangers of smoking.

Some hospitals were ready to begin the broader ban earlier, but executives agreed to postpone the date to join with others. Hospital leaders formed the Tobacco-Free Hospital Collaborative and plan to hold a news conference Tuesday at the Montgomery County Conference Center in North Bethesda.

Executives thought that joining together ‘‘would have a bigger impact,” said Yolanda Gaskins, a spokeswoman for Holy Cross in Silver Spring.

The hospitals’ ban is an important step, said Laurie Fenton Ambrose, president and CEO of the Lung Cancer Alliance, a Washington, D.C., nonprofit. ‘‘We just hope it will spread to other health centers around the country,” said Ambrose, who spoke recently at the first Washington Adventist Hospital Lung Cancer Symposium.

Health care leaders need to set an example for the community, said Alfred Munzer, director of pulmonary medicine at Washington Adventist. ‘‘The hospitals are taking a leadership position and saying this is wrong,” he said.

In addition to cigarettes, the centers are banning cigars, tobacco products in pipes and smokeless tobacco, including dip and snuff. The hospitals now allow limited smoking on their campuses in designated areas and in smokers’ vehicles.

Hospital leaders have sent information to physicians, with tips on how to prepare tobacco-using patients for hospital stays. Nicotine-replacement tools such as gums and patches will be available in gift shops.

‘‘For a patient to come into the hospital, then wheel out their IV pole and smoke, it wasn’t uncommon,” Lichty said. ‘‘We have to make sure physicians inform their patients beforehand about this.”

Mixed emotions

Smokers outside of Shady Grove Adventist had mixed emotions about the ban.

‘‘Overall, I think people’s rights are being taken away,” said Joe Pelkey, an ambulance driver from Thurmont. ‘‘They need to stop picking on cigarette smokers and focus on alcohol. That’s the real killer.”

Excessive alcohol use is the third leading lifestyle-related cause of death in the United States, responsible for about 75,000 deaths annually, according to the CDC. Smoking and obesity rank above alcohol use, according to the agency.

Pelkey said he has written O’Malley and his senators about smoking bans, saying the government is changing laws it has no right to change.

‘‘Say you’re a nonsmoker, but your wife or girlfriend smokes, so you smell like [smoke],” he said. ‘‘What are they going to do then?”

Others thought the change would be beneficial.

‘‘I guess it’s good,” said Jennifer Mason of Gaithersburg. ‘‘If it makes the patients better, then that’s all that matters.”