Outdoor smoking ban at a cancer center: attitudes and smoking behavior among employees and patients

J Public Health Manag Pract. 2012 Sep-Oct;18(5):E24-31. doi: 10.1097/PHH.0b013e31822d4bb5.


Policies restricting indoor worksite tobacco use began being implemented more than a decade ago. More recently, the scope of these policies has been expanding to outdoors, with hospitals leading the trend in restricting smoking throughout their grounds. However, research on the effects such bans have on employees is scarce. The purpose of the current study was to examine the impact of a campus-wide smoking ban on employees and patients at a cancer center. Employees completed anonymous questionnaires during the months before (n = 607; 12% smokers) and 3 months after the ban implementation (n = 511; 10% smokers). Patients (n = 278; 23% smokers) completed an anonymous questionnaire preban. Results showed that 86% of nonsmokers, 20% of employees who smoke, and 57% of patients who smoke supported the ban. More than 70% of smokers were planning or thinking about quitting at both time points and nearly one-third were interested in cessation services following the ban. Before the ban, 32% expected the ban to have a negative effect on job performance and 41% thought their smoking before and after work would increase. Postban, 22% reported a negative impact on job performance, 35% increased smoking before and after work, and 7% quit. Overall, these data revealed an overwhelming support for an outdoor smoking ban by nonsmoker employees and patients. Although a majority of employee smokers opposed the ban, a significant proportion was interested in cessation. Compared with preban expectations, a lower proportion experienced negative effects postban. Findings suggest a need for worksite cessation programs to capitalize on the window of opportunity created by tobacco bans, while also addressing concerns about effects on work performance.

MeSH terms

  • Adult
  • Cancer Care Facilities / standards*
  • Environmental Exposure / prevention & control
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Inpatients / statistics & numerical data*
  • Male
  • Medical Staff, Hospital / statistics & numerical data
  • Middle Aged
  • Occupations / statistics & numerical data
  • Public Policy
  • Smoking / epidemiology*
  • Smoking / psychology*
  • Smoking Cessation / legislation & jurisprudence*
  • Social Class
  • Southeastern United States / epidemiology
  • Surveys and Questionnaires
  • Tobacco Smoke Pollution / legislation & jurisprudence*
  • Tobacco Smoke Pollution / prevention & control


  • Tobacco Smoke Pollution