Reduction in staff smoking rates in North Coast Area Health Service, NSW, following the introduction of a smoke-free workplace policy.

AIM: To evaluate changes in staff smoking rates following the implementation of Smoke Free Health Care, an innovative, change-management process that introduced a smoke-free workplace policy in the North Coast Area Health Service of NSW. METHODS: Survey questionnaires were sent to all staff before and after the introduction of the policy. Return rates were 17.3% (690/3988) in 1999 and 25.4% (2012/7921) in 2007. Chi-square tests and multivariate logistic regression analysis were used to determine differences. RESULTS: Staff smoking rates decreased significantly from 22.3% to 11.8% (p<0.0001). Smoking rates in 1999 were not significantly different to the state population's (22.3% and 24.1%, p=0.3), but were significantly different in 2007 (11.8% and 20.1%, p<0.0001). Over a quarter (27.6%) of staff who smoked when implementation began quit smoking; more than twice the rate before implementation (12%, p<0.0001). CONCLUSION: These changes in staff smoking rates indicate the effectiveness of a comprehensive change-management approach to implementing smoke-free workplace policy.

Smoke free health care: an organisational change to increase effective intervention for tobacco.

In 1999, the NSW Health Smoke Free Workplace Policy directed that grounds of health sites would become smoke free, in addition to the existing policy requiring smoke-free buildings. This was one of the first attempts by any health service to exclude tobacco entirely from health sites. This task required the adoption of evidence-based management of tobacco dependence and changing the culture of smoking in the health service. There were many barriers to implementation.