Providence Hospital Goes Smoke-Free

Facility Becomes First in D.C. to Implement Campuswide Ban

Andrew Carroll, who works at Providence Hospital, has quit smoking in part by using the hospital's cessation classes and aggressive exercise. (By Lois Raimondo -- The Washington Post)

The biggest notices, bright blue and unavoidable, are posted at all the driveway entrances to Providence Hospital. Outside its doors are more signs with the telltale slash mark. And on a lawn gazebo, which until Jan. 1 was one of the last remaining refuges, is this polite but firm directive:

"Providence Is Now Tobacco Free. No Smoking, Please. Thanks."

Throughout the campus of the Northeast Washington hospital, lighting up is now off-limits -- banished from porticos, walkways, even the parking areas and loading dock.

The prohibition makes Providence the first health-care facility in the District to declare its property puff-and-snuff free and one of the few in the region, joining the likes of Johns Hopkins Hospital in Baltimore, Civista Medical Center in La Plata and Mary Washington Hospital in Fredericksburg.

But the number of area facilities in this category could increase quickly. Montgomery County's five private hospitals are aiming to make the switch as a group this year. Others are in discussions.

They're all part of a national trend, one that many people say is way overdue. "Hospitals are supposed to be places of healing and health, so it only makes sense that they'd be smoke-free," said Bronson Frick, associate director of Americans for Nonsmokers' Rights. The California-based organization maintains a list of hospitals proclaiming that status -- more than 500 as of this month.

Administrators offer multiple motivations for their actions, from promoting good health and a healthy environment to boosting employee productivity and cutting maintenance costs. Not to mention, added Ronald Davis, president-elect of the American Medical Association, "the issue of our image. It's tarnished when one sees a crowd of smokers or a pile of cigarette butts outside our doors and in our courtyards."

The pioneer was the Mayo Clinic in Minnesota, which went cold turkey in 1987. It was on its own for a long time. Only in the past several years, as more cities and states passed laws against smoking in the workplace, and especially in restaurants and bars, have enough hospitals followed suit to constitute a true movement.

Last year saw a sharp spike, with such institutions as the University of Rochester Medical Center in New York signing on. In tobacco-rich states like North Carolina and South Carolina, Frick said, more than 30 hospitals extinguished cigarettes.

U.S. Surgeon General Richard H. Carmona's massive 2006 update on "The Health Consequences of Involuntary Exposure to Tobacco Smoke" was undoubtedly an impetus. "Second-hand smoke is not a mere annoyance," Carmona stated at the report's release. "It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults."

About 20 percent of Providence's employees smoke, although administrators do not have a breakdown by job description. Some health providers have higher numbers than others. Among physicians nationally, surveys show a tobacco-use rates of less than 5 percent. Use among nurses is several times that, with as many as one in four licensed vocational nurses smoking.

Providence administrators worried that the sight of staff, visitors or others outside smoking whether on break or en route to their cars, diminished the hospital's cessation efforts. And looking the other way implied tacit approval, they thought.