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Hospitals and prisons should be smoke-free

Raymond Reid objects to the change in the tobacco policy for Moses Cone Health System prohibiting tobacco use on all its sites starting July 1 (letter, Jan. 19).

In the 1960s, I kept an ashtray in my desk for use by patients and relatives to smoke after hearing reports that revealed bad news. I was sensitive to the emotions and the nicotine addiction of my patients, which still is important to Reid. But in 2006, Moses Cone administrators feel tobacco is such a health hazard, it should not be used on its property. Thirty other hospitals in North Carolina have identical policies, and I applaud this powerful statement.

As to the restrictions on prisoners smoking, Reid is correct that inmates may smoke in outside areas within most jails in North Carolina. However, in three "model" prisons, all tobacco use, both inside buildings and in yards, is prohibited.

It is anticipated this policy will be expanded to the rest of the prison system next year. While lawmakers had reducing health care costs as their primary goal, inmates throughout North Carolina may find incarceration so inhospitable to their nicotine addiction that recidivism rates will fall.

Richard J. Rosen, M.D.
Greensboro

Comments (21)

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Scott_Free [TypeKey Profile Page] said:

I smoke and fully accept that smoking is not a healthy choice to make and that it is addictive. The fact that the medical profession acknowledges that it is addictive can only lead me to the conclusion that the changes in tobacco policy at medical centers is to punish and denigrate those who partake in a practice they frown upon. Such a policy is not going to result in visitors to the hospitals giving up the habit. While I fully agree that non-smokers should not be subjected to second-hand smoke in indoor areas, in hospitals that had outdoor smoking areas, no non-smokers were harmed whatsoever. Restricting smoking from the grounds means family members of patients will have to leave the property, often resulting in increasing already exhorbitant parking fees. I resent such policies, especially since family members are often practically required to stay with ill family members for long periods of time because support services in many hospitals can be so negligible these days. I will accept that I am a weaker person than non-smokers when it comes to relieving stress, but when I had a dying family member and had to stay long periods at the hospital, my occasional smoke in an outdoor smoking area helped me cope immensely. I fully support the medical profession in its endeavors to educate the public and reduce tobacco use. However, tobacco use is still legal, and I can only see these actions as cruel and mean spirited. It makes me have less trust in the profession.

littlebuddababy [TypeKey Profile Page] said:

Why shouldn't a private company be able to ban smoking on their property. Schools do it, corportaions do it. Heck, evne most home owners will ask you to stop away from their homes if you insist on smoking.

Smoking in outdoor areas does not eliminate the exposure of non smokers to the dangers of second hand smoke.

I smoked for about 10 years. When I found out that I was pregnant I stopped immediatly. I ahve not required others not to smoke around me, I have simply removed myself from their presence. While I feel that this is the easiest action it can not always be that way. Especially in outdoor areas near hospitals where people have to pass smokers while walking in and out of the doors.

There are outdoor buildings where smoking is allowed, but in the times that I have visited the hospitals I have seen numerous people still smoking next to doors and even out on verandas connected to waiting rooms. Smoke from these areas floats in and out of the main building because people are not in the designanted areas. Since hospitals do not want to have to pay people to police these areas, then what other choice do they have.

As for people who are having to stay at the hospital for long periods and having to do without smoking, think about the person you are visiting. If they are a smoker, then I am sure they will appreciate the fact that you are doing with out just as they are.

It is your right to smoke. It is a non-smokers right not to have to breath your smoke. If you are in an environment where the non-smokers can not get away from your smoke, or must pass through it to get somehwere, then please, show some respect. Living without that cigarette for a few hours won't kill you, actually, going without it can do nothing but good.

mrproduce [TypeKey Profile Page] said:

inmates throughout North Carolina may find incarceration so inhospitable to their nicotine addiction that recidivism rates will fall.

Yeah, just like they have to do with out drugs while in the clink. Best place in the world to get a fresh supply of drugs is in prison. So stopping smoking is going to do what?
You gotta be kidding, surely.

yellowdog [TypeKey Profile Page] said:

i think a hospital is a little different than a typical 'private' business like a restaurant. if a restaurant says no smoking, you can easily go to another restaurant nearby. if a hospital says no smoking, it's kinda hard to pack up and go to one across the street.

i have no problem with people not being allowed to smoke INSIDE the hospital. but OUTSIDE? that's taking it too far.

neocon [TypeKey Profile Page] said:

I don't see the problem with being able to light up outside where the benefits of breathing the carbon monoxide from all the traffic more than offsets the health hazzards of tar and nicotine from cigaretts.

Whenever the smoke in a restaurant gets to be too much for me, I simply step outside and take a few deep breaths of the exaust fumes from one of those city buses. Works for me.

Kat in the Hat [TypeKey Profile Page] said:

Raymond Read,
I also object to the new policy at Cone Hospital!!! What about the mental and physical effects for the smoker willing to go to the smoking hut? We pay taxes for that hospital too! The hospital may be a private business, but who pays for the bills those customers are not paying. You and I do in higher insurance rates and co-pays. We were not born yesterday, even though some would have us believe such.
Scott_Free,
You are correct. The hospital wants to be politically correct. It's the going thing now. Punish the legal smoker even though some follow the rules. Who cares, they are now considered to be trashy people now by a lot of non-smokers.
I can't wait to see what is banned in public next. Maybe it will be one of their bad habits.
Thank you mrproduce, yellowdog, and neocon for caring about our few personal liberties we have left. We pay for the use of the hospital, outragous taxes for the smokes and then are slapped in the face for using a legal product.

Dan [TypeKey Profile Page] said:

The prisons should at least let the lifetime inmates smoke. That will reduce their lifespan and save on tax dollars.

Bobby [TypeKey Profile Page] said:

It is a shame that smoking has been criminalized by so many. It is a legal product that has been that way before this country was founded.

I quit smoking years ago, but that was my choice. If someone had threatened me the way it is done now, I would still be smoking. There should be equal places for smokers as non-smokers. Fair is fair. Alot of those screaming the loudest are ones that have quit and now think it is their duty to make you quit. It isn't, that is your choice to make. You health choices are that, YOURS, not mine or theirs.

Secondhand smoke has NEVER been proven to cause a health hazard, discomfort maybe, but not health hazards. If I am bothered by someone smoking in an area that is sat aside for them, then it is my responibility to leave, not them.

Yvonne [TypeKey Profile Page] said:

Bobby, I agree adults should be able to make decisions about their own health. However, I would like to present a point of view that has not been touched upon in this thread.

Kat presents the arguement that her tax dollars are going to pay for the hospital because of non-paying customers. She states we, the taxpayer, pays in the form of higher insurance rates and co-pays.

The flip side of that coin is the higher co-pays and insurance rates, while losing benefits, is also a direct result of the exorbitant amount of money smokers costs the insurance companies and the taxpayer. Tens of billions of dollars are spent on treating the health problems smoking causes.

I have been in the medical profession for over twenty-five years. If I had a penny for every dollar Medicare and Medicaid alone has spent on smoking related illnesses in that time period, not counting private insurance companies, I could easily retire.

So, in essence, the personal health choices of smokers affect us all where it hurts the most, in the wallet. It is not JUST a matter of whether second-hand smoke is harmful or not (which, btw, it has been proven to be so). Everyone pays for the "personal choice" of smokers.

shippy [TypeKey Profile Page] said:


Dr. Rosen:

I do not smoke, have smoked less than 1/2 pack in my entire life of almost 60 years! My wife does not smoke nor do any of our extended family! Thank goodness! Do not do drugs either!

I feel if you and moses cone and others are going to make a statement about health and "force it on others" you need to not be wimps about it! You need to stand up for health and not the current fashionable public whipping boy! What does this mean?

1. Remove all fast food products from the private medical office complexes and hospital grounds!
. Coke
. Pepsi
. snacks of most types
. Do not sell it in the "stores"

3. Revamp the foods allowed to be served in the cafeteria eliminating the above and significantly reducing fat and calorie selections!

3. Fire every employee whose weight is 20% over recommended! This would almost eliminate the nursing population and many doctors and a large percentage of the administrative staff!

4. Put on notice every other employee who is in the the 1- 20% category that their job is in jeporady!

3. Require all employees to stay after work at their expense and do a qualified exercise and stress relief program! (Medical complex to provide equipment no cost!

4. Any employee, staff, doctor, services provider
caught with alcohol, observed drinking acohol, showing medical symptoms of alcohol abuse or in any other detectable method acknowledging acohol will be fired! This includes medical conventions!

5. Since we do not tolerate bad behavior, We the above providers will not treat patients who are overweight, smoke, drink, or have bad eating habits!

At this point you and your colleages can say that you have made a powerful statement regarding public health!


What a bunck of hyprocrits!

john moore

yellowdog [TypeKey Profile Page] said:

yvonne makes some good points if the discussion is an outright ban on smoking. (which I've no doubt she'd support) but we aren't talking about that. we're talking about now allowing people to smoke outside a hospital.

littlebuddababy [TypeKey Profile Page] said:

Dan: Good Point
Shippy: Coke as well as fatness does not cause cancer in not fat people and non coke drinker.
By, the way have you tasted the food in those cafaterias lately, they have taken so much out that the blandness is unbelieveable.
Yellow Dog: It is still private property. Yes, you have to go there if you want (not need) if you want medical care. You can always choose not to go. However, since most of the patients are not the ones who are loosing the ability to go outside and smoke, it is the visitors who are the ones who will suffer the most. Last time I checked going there was still voluntary. As for the restuarant reference, if all of your friend were there and you wanted to see them, you would have to choose between your smoke and your friends.
As far as smokers who have quit trying to convince people who smoke to quit, I mean really, is that so bad? I have the right to voice my opinion and you have the right to walk away or ignore me. But, if you are trying to argue a point about being able to smoke in public areas then I feel compelled to argue the other side of the coin.

Please try to think about this. Even if you are outside, your smoke still gets to other people. At Moses Cone, the outside smoking areas are right between the parking ares and the entrances. Now I would be all in favor of keeping the smoking huts, as long as they move them to the back of the parking lot where nobody has to psas by them to get to or from their cars.

If you are at a hospital for a particularly long time, as I was with my grandmother last year. Perhaps you should consider buying a pack of nicorette to help get you through.

As for anyone else who feels they are being picked on, I just want to say. I have never, I me n.e.v.e.r met a smoker who has not told me that they wish they could or would quit.

DemonDeacon [TypeKey Profile Page] said:

Dan,
Great comment. You are always trying to help a man when he's down!
Others:
As long as the smoking area is NOT right outside the entrance doors, I don't care where they put it at the hospital. Smoking should NEVER be allowed inside a hospital for the reasons put forth above by Yellow Dog and others.

Dan [TypeKey Profile Page] said:

Glad you liked my comment Deac. I was waiting for either you or Denzien to comment on it but I thought your response would be a bit more harsh.

Buddabuddy, the patients smoke too whence in hospital care. I visit a lot of hospitals for my job and constantly see people in front of the hospital in their wheelchairs, IV bag & all, out to get a smoke. Pretty sad.

I can't stand cig smoke but as long as it's not right at the front entrance where I have to breathe it, then smoke away. Many hospitals do have the smoking huts tucked away somewhere else.

I just thank God everyday I finally kicked that habit. Last smoke was 12/31/1999.

Kat in the Hat [TypeKey Profile Page] said:

Yvonne,
I stated and you stated:
We pay taxes for that hospital too! The hospital may be a private business, but who pays for the bills those customers are not paying? You and I do in higher insurance rates and co-pays.
I can't wait to see what is banned in public next. We pay for the use of the hospital, outrageous taxes for the smokes and then are slapped in the face for using a legal product.

Kat presents the arguement that her *(I stated our/we/You) tax dollars are going to pay for the hospital because of non-paying customers. She states we, the taxpayer, pays in the form of higher insurance rates and co-pays.

I guess then we will end up with no hospitals for the smoker? Inside or out? Thanks for the 25 years of compasion. I think I will just die outside if it is ok with the non-smokers.

Thanks shippy and john moore, yellowdog, and bobby, you made some great points in your blogs.

I am not poor enough or old enough for Medicade or medicare, but if I ever am, I hope that I have a nurse that has compassion not judgement for my life style choices.

Yvonne [TypeKey Profile Page] said:

Kat, I did not condemn you for your choices. I merely presented the flip side of the coin that you tossed into the discussion. The part about taxpayers and who pays for what. Perhaps you did not want anyone to bring up that non-smokers' money is also paying for your smoking habit. If that is the case, you should not have gotten your drawers in such a wad about your tax money.

Early yesterday morning, one of my patients, who has severe COPD and still smokes, had to be intubated AGAIN. Contrary to the picture you paint with your assumptions, she could not have had any better care from anyone. Nor could she have received more compassion. I have worked with respiratory patients for lots of years and have always given good care, whether they smoked or not.

The fact that I presented the cost of smoking to the general public was no reason to attack my integrity. I did not judge you or anyone else so why do you feel it is OK to judge me?

I do understand smoking is an addiction. And I feel for those who do not have the willpower to kick the habit. But that does not mean I am happy that my tax dollars are paying for your personal choice. End of story.

yellowdog, Actually, I think a hut in the back of the building for smokers, away from the non-smoking public, would be a compromise from both camps.

Kat in the Hat [TypeKey Profile Page] said:

Yovnne
Somehow our wires have gotten crossed and I am sorry that it has happened.
The point I am trying to make with you is that we all die from something.
Our tax dollars I speak of are for equal treatment OUTSIDE of the hospital for smokers away from the public. This would in no way harm the non-smoker. Can we agree on that?
I know that the hospital owns the property and can determine who smokes where. But our tax dollars cover all of the property, if I am not mistaken.
I feel that you are cherry picking the sickness from which we die INSIDE the hospital and that is a whole different issue imho.
The old law of an eye for an eye
leaves everybody blind.
--Martin Luther King, Jr.
An essential aid to following the path of the inner voice is practicing forgiveness. Resentment comes from the Latin word resentir to feel over and over again. By repeatedly re-experiencing the old resentments, we are less apt to hear our intuition, which exists only in the present.
When Jean married, she had not completed her unfinished business with her father. Consequently, she projected her old resentments onto her husband. Her desire to love him was distorted by the hurt and anger from the past. This is why it is said that until we complete our source relationships, we are never truly in another relationship.
Forgiving can also help you take back your power. As long as you believe that someone else's actions are the cause of your present difficulties, you are powerless to change. Letting go of blame allows you to take responsibility for your life.
All this adds up to a single point. Forgiveness is an act of self-kindness. It liberates your life force. It completes the past. Choose now to heal your old unfinished business. It is time to let go of the pain.
Set your self and others free.
May Peace be with you and yours.

Kat in the Hat [TypeKey Profile Page] said:

Yovnne
Somehow our wires have gotten crossed and I am sorry that it has happened.
The point I am trying to make with you is that we all die from something.
Our tax dollars I speak of are for equal treatment OUTSIDE of the hospital for smokers away from the public. This would in no way harm the non-smoker. Can we agree on that?
I know that the hospital owns the property and can determine who smokes where. But our tax dollars cover all of the property, if I am not mistaken.
I feel that you are cherry picking the sickness from which we die INSIDE the hospital and that is a whole different issue imho.
The old law of an eye for an eye
leaves everybody blind.
--Martin Luther King, Jr.
An essential aid to following the path of the inner voice is practicing forgiveness. Resentment comes from the Latin word resentir to feel over and over again. By repeatedly re-experiencing the old resentments, we are less apt to hear our intuition, which exists only in the present.
When Jean married, she had not completed her unfinished business with her father. Consequently, she projected her old resentments onto her husband. Her desire to love him was distorted by the hurt and anger from the past. This is why it is said that until we complete our source relationships, we are never truly in another relationship.
Forgiving can also help you take back your power. As long as you believe that someone else's actions are the cause of your present difficulties, you are powerless to change. Letting go of blame allows you to take responsibility for your life.
All this adds up to a single point. Forgiveness is an act of self-kindness. It liberates your life force. It completes the past. Choose now to heal your old unfinished business. It is time to let go of the pain.
Set your self and others free.
May Peace be with you and yours.

Yvonne [TypeKey Profile Page] said:

Kat, As I said in at least two different posts, I think a building away from the entrance and the non-smoking public is a viable alternative for the smoking public. My issue with smoking is NOT the actual act itself (for adults) but rather where it transpires. My major issue has always been with smoking in public places and at the entrance of public places.

The hospital I work for has built a gazebo for the smoking public that is 35 or 40 feet from the main entrance. I thought that was a fair compromise. But almost every evening, when I go to work, folks are either at the entrance smoking or there are ciggy butts scattered around on the cement at the entrance. This is a real sore spot for me as I have a true allergy to smoke. But most smokers I come in contact with could care less about the non-smoking public. And in fact see us as the enemy.

I am not sure what forgiveness has to do with my stance on smoking. From my perspective, smokers are the ones hating those of us who are aganist smoking in public. They are also blaming us for their ills, trampling on their "rights" and creating an attitude of superiority. All because non-smokers are becoming more vocal about their "rights". Personally, I think we are all equal as humans, no one superior as a human. However, I do think some people's behaviors are exceptional and some folk's behaviors less desirable. This does not equate to superiority amongst non-smokers, imo.

I see no attempt for compromise in most smokers but I do not think they are the cause of the ills in my life. It has always been my belief that life is about the good and bad. As I have said many times, I am an exceptionally blessed person. I thank God daily and always give Him all the glory.

Since the topic of this thread is smoking on the grounds of the hospital, I don't see how I am cherry picking to offer an opinion about the cost of smoking to the general public when the issue of tax money is brought up (which I did not bring up). This was the point I was trying to make. Sure, we are all going to die of something and it will cost taxpayers in some way. But "something" is not the topic, smoking is.

Peace to you also, Kat. My purpose here is not to create ill-will and if I stepped on your toes, I apologize. This is a public forum, however, and I think we can disagree without becoming disagreeable. Thank you for your understanding.

lilbean [TypeKey Profile Page] said:

its no big secret why the federal or local governments won't classify nicotine as an addictive drug. in doing so they would be compelled to treat inmates they way they have to treat a heroin addict. and government employees would also be subject to drug test that include nicotine.
the private sector should be left just that, private. each business should be allowed to form their own policies, not regulated by opinion swayed politicians.
personally, it would not bother me a bit if big tobacco companies decided to pack up and move their operations overseas to a more business friendly enviroment. the assault that has been levied on them for the last decade by those who reap financial gain from tobacco sales is totally hypocritical.
as far as health issues go, far more people die each day from alcohol related issues than do tobacco related ones.one drunk driver can wipe out an entire family in a second. does the same apply to a smoker in a restraunt? so, to the hypocrit politicians and do-gooders, if you must attack the tobacco companies, why won't you also attack the alcohol industry? cowards.

Yvonne [TypeKey Profile Page] said:

lilbean, You are wrong about the comparison of smoking related deaths yearly to alcohol related deaths yearly. It is harder to find information about alcohol because most sites want to group alcohol with other drugs. But if you are diligent in your search, you will find the same info I found. Following info:

"Tobacco use is the leading preventable cause of death in the United States.1 Cigarette smoking causes an estimated 440,000 deaths, or about 1 of every 5 deaths, each year.2,3 This estimate includes 35,000 deaths from secondhand smoke exposure.

Country Tobacco Alcohol All drugs Ecstasy
United States 400,000 100,000 15000 ? "


"Estimated U.S. deaths in 2000 attributed to:

Tobacco (Average 1990 - 94): ................................. 430,700 (1)
Alcohol (1996): ................................................. 110,640 (2)"

As you can see, tobacco related deaths far out number alcohol related ones. However, the one common factor regarding both is, they both are preventable. Over half a million US citizens are dying yearly from conditions that are preventable.

The major difference in smokers and drinkers is, a drinker can drink themselves into a coma and it does not affect the non-drinking person in his/her area. The smoker affects everyone in his/her vicinity when they light up. Sure the drunk can get behind the wheel of a car and kill someone, but not every drunk does. However, every smoker who lights up contaminates the air for every non-smoker in his/her area.

Two wrongs have never made a right. Drinking and smoking are not wrong (imo) UNLESS the ones engaging endanger the general public. That is why I think a smoking hut away from the public is a fair alternative, in the case of MCH.

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