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. 2018 Dec 11;18(1):1365.
doi: 10.1186/s12889-018-6231-x.

The Impact of a Social Norms Approach on Reducing Levels of Misperceptions Around Smokefree Hospital Entrances Amongst Patients, Staff, and Visitors of a NHS Hospital: A Repeated Cross-Sectional Survey Study

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The Impact of a Social Norms Approach on Reducing Levels of Misperceptions Around Smokefree Hospital Entrances Amongst Patients, Staff, and Visitors of a NHS Hospital: A Repeated Cross-Sectional Survey Study

Scott Crosby et al. BMC Public Health. .
Free PMC article

Abstract

Background: Smoking is a cause of avoidable morbidity and mortality. In the United Kingdom (UK) the national smoking ban inside hospital buildings is widely adhered to. There is a perception it has led to smokers congregating around hospital entrances (Selbie D. 2016, It's time for a truly smokefree NHS. Public Health Matters Blog. Public Health England). Efforts to shift social norms and create positive smokefree environments might be strengthened by delivering social norms messages. This study explored the impact of a social norms approach campaign to reduce levels of misperceptions surrounding support for smokefree hospital entrances.

Method: Repeated cross sectional study design. Staff, patients, and hospital visitors at Pinderfields National Health Service (NHS) Hospital (Wakefield, United Kingdom (UK)) completed a survey before and after implementation of a public health social norms campaign (n = 481 surveyed before; n = 459 surveyed after). The main outcome measure was difference between perceived and reported levels of support for smokefree hospital entrances.

Results: There were high levels of support for smokefree hospital entrances. The majority of participants agreed that patients (n = 849, 90% agreed), staff (n = 863, 92% agreed), and visitors (n = 850, 90% agreed) should not smoke in the hospital entrance. Participants underestimated the proportion of others who self-reported keeping the entrance smokefree. Over 90% of respondents reported not smoking in the hospital entrance, but the perception was that between 50 to 75% of hospital staff, patients, and visitors did not smoke in the hospital entrance. The mean percentage of hospital staff, patients, and visitors who respondents thought did not smoke in entrances was higher for respondents responding after, compared to those responding before, the campaign. There was an overall significant effect of time on attitudes towards smoking in the entrances; in all instances the mean percentage of hospital staff, patients, and visitors the participants believed agreed that hospital entrances should be smokefree was higher for those responding after, compared with before, the campaign.

Conclusions: People hold misperceptions of the proportion of people who choose to smoke in the hospital entrance. The social norms approach campaign was associated with a strengthening of positive social norms. Such campaigns should be considered by Trusts as one evidence-based based tactic to denormalise smoking, increase support for smokefree policies.

Keywords: Public health; Smokefree; Social norms; Tobacco control.

Conflict of interest statement

Authors’ information

Not applicable.

Ethics approval and consent to participate

Research and Development approval was received (Mid Yorkshire NHS Trust). The study was approved as an audit and evaluation of smoking behaviour on Pinderfields hospital grounds. R&D Permissions were granted via NHS Wakefield. The manuscript reports on aggregated data only, it does not contain data from any individual person. All participants were provided with information on the audit to enable them to make an informed decision as to whether or not to participate in the audit. Consent was deemed to have been given if individuals completed and returned the pen and paper survey. Individuals had the right to refuse to participate; due to anonymous completion of the survey once surveys were returned it was not possible for data to be withdrawn. In consenting to take part in the audit participants also consented to their responses being included in the dissemination of results.

Consent for publication

Not applicable.

Competing interests

GS and BE co-founded Magpie Communications (the marketing agency who created the social marketing campaign). SC, DB, BB declares that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Examples of intervention material displayed on and around Pinderfields hospital

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References

    1. Wanless D. Securing good health for the whole population. London: HM Treasury; 2004.
    1. Bosdriesz JR, Willemsen MC, Stronks K, et al. Socioeconomic inequalities in smoking cessation in 11 European countries from 1987 to 2012. J Epidemiol Community Health Published online first. 2015;69(9):886-92. 10.1136/jech-2014-205171. - PubMed
    1. Peto R, Lopez AD, Boreham J, Thun M, Heath C. Mortality from smoking in developed countries, 1950–2000: indirect estimation from national vital statistics. Oxford: Oxford University Press; 1994.
    1. Newton JN, et al. Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the global burden of disease study. Lancet. 2013;386(10010):2257–2274. doi: 10.1016/S0140-6736(15)00195-6. - DOI - PMC - PubMed
    1. Health & Social Care Information Centre. Statistics on Smoking , England (PAS). England; 2017. https://digital.nhs.uk/catalogue/PUB24228. [Accessed on 1 Dec 2017].

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