Ending smoking at the Johns Hopkins medical institutions: an evaluation of smoking prevalence and indoor air pollution

Article Abstract:

Johns Hopkins is a large medical center incorporating a major medical school and postgraduate training program. This study documents the responses of staff and visitors to a smoke-free environment. Staff evaluation before and in the months following the smoking ban were followed by survey. Observations in public places such as lobbies, waiting rooms, food service areas, and public bathrooms were carried out to measure compliance. A 25 percent reduction in smoking rate of staff, and a 25 percent decrease in number of cigarettes consumed by smokers in all occupational categories occurred in the period following the ban. Levels of nicotine through out the hospital were significantly lower, as was the degree of public smoking. The number of fires directly traceable to smoking declined from an approximate yearly rate of 20 to none following the ban. The number of cigarette butts found in ashtrays fell greatly in all areas of the hospital except bathrooms. Bathrooms continued to be used by smokers, as a means of avoiding the smoke-free conditions of the hospital. The hospital staff and patients appeared to accept the ban with relative ease, showing that an affirmative hospital policy can markedly decrease the environmental levels of smoke and nicotine. The study shows that institutions that fail to initiate a smoke-free environment because of presumed resistance, can do better by providing an organized approach that includes health promotion activities to their staff who smoke. The obvious mission of health institutions such as Johns Hopkins is to foster good health and reduce the burden of disease. Providing an environment for workers, patients and visitors that is free of smoke and smoking byproducts is an important contribution. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Environmental aspects, Smoking cessation programs, Smoking cessation, Indoor air quality

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Factors related to functional status after coronary artery bypass surgery

Article Abstract:

The goal of coronary artery bypass surgery (CAB) is to re-establish blood flow to the heart by circumventing blocked areas of the coronary vessels. When successful, this operation improves the physiologic status of the heart and affords patients increased physical capabilities and a marked reduction in angina (chest pain). However, in many cases, the resumption of social and leisure activities following CAB surgery is not commensurate with measurable cardiac improvements. The present study explores this paradoxical finding. In particular, the psychosocial and underlying psychiatric concerns of CAB patients are evaluated, including patients' feelings of confidence about returning to a fuller life following their operations. The study enrolled 125 eligible, consecutive, male patients who underwent CAB surgery. The patients received various psychosocial tests prior to and after CAB. The results of these evaluations were then statistically related to the objective physiologic results of the surgery. Although there were generally profound physiologic improvements, 13 percent of the patients continued to report restrictions in their physical abilities, and 45 percent reported difficulty or failure to become involved in moderate physical activity. The best correlation with these outcomes was found to be the patients' estimates of their physical capabilities, which may not be a good index of their actual physical abilities. These data suggest that rehabilitation programs should focus on providing patients with a more accurate and realistic self-concept of their own abilities. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Physiological aspects, Prognosis, Cardiac patients, Coronary artery bypass

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The impact of a total ban on smoking in the Johns Hopkins Children's Center

Article Abstract:

Smoking has been banned throughout the Johns Hopkins Children's Center since Jul 1987. The percentage of smokers who smoked at work declined from 82 to 43 percent. Before the ban, 43 percent of smokers and 83 percent of nonsmokers agreed that a hospital should be smoke-free. After the ban was imposed, 66 percent of smokers and 93 percent of nonsmokers agreed with the smoke-free policy. One month before the ban, 53 percent of visitors and staff smoked in public areas; six months after the ban, no one did. The number of cigarette butts found per day in elevator lobbies declined from 940 per day a month before the ban to 19 per day 6 months after the ban. The level of nicotine in the air of nine lobbies declined from 13 to 0.5 micromoles per cubic meter. These results suggest that a total smoking ban is feasible and can virtually eliminate public smoking.

Health aspects, Laws, regulations and rules, Hospitals, Children, Smoking

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