Providence Hospital Goes Smoke-Free

"There's never any legitimate reason to allow smoking," noted President Julius D. Spears Jr., whose father, a three-pack-a-day addict, died of lung cancer at 66.

In this region, the most anti-smoking activity has occurred in Maryland. Civista Medical Center does not allow tobacco products except in "the privacy of one's own vehicle." Johns Hopkins Hospital's still-evolving policy tries to be equally strict; it has barred smoking in garages or exterior areas within its campus perimeter, although the city streets and sidewalks that cut through the campus make enforcement more difficult.

The Maryland Hospital Association recently posted on its Web site a lengthy list of how-to resources from across the country. "I can see major progress," said Senior Vice President Nancy Fiedler, who estimates that a dozen facilities statewide already have forbidden all outside smoking. Another dozen are well along in their planning.

Calvert Memorial Hospital in Prince Frederick soon will dismantle several public smoking shelters and close its staff smoking zone, and by June 1 all cigarettes, cigars and pipes will be outlawed. Montgomery's hospitals haven't set their target date, but they've agreed on a united front.

"We're all going to go at the same time," said Judy Lichty, director of prevention and wellness programs for Adventist HealthCare, which itself is going to go further still. The organization will extend the ban well beyond Washington Adventist and Shady Grove Adventist hospitals to its half-dozen nursing homes and all other Maryland locations and offices.

Zero tolerance can be a challenge, though.

"This has not been an easy implementation," admitted Fred Rankin, chief executive of Medicorp Health System and its flagship Mary Washington Hospital. After decreeing an end to smoking on the hospital's sprawling grounds, officials grappled with enforcement. They finally decided to return a small, single, out-of-sight "butt hut" down the hill from the emergency department entrance. It remains restricted to non-employees who just can't manage without a cigarette while at the hospital.

"We tell them, 'Here is our policy. We encourage you to comply,' " Rankin said. But "the addiction of smoking is incredibly strong. . . . We have the occasional patients who will get out of bed and go down and stand outside in their bathrobe and have a cigarette."

There have been few scofflaws to date at Providence Hospital, which first issues verbal and then written warnings to errant workers. Not that some haven't grumbled about the campus's new designation. In 35-degree chill this week, Mike Jones stood at the curb -- on public space -- to have a smoke.

"I understand people don't want to be around us," said Jones, who works in insurance billing. He questioned whether the entire property should be marked off. "We're already outside."

According to Providence's president, only one employee has quit in protest; numerous others have enrolled in its free program to help them break their habit. "We have easels up all over the place [that advertise] 'Here's the number to call,' " Spears said.

Andrew Carroll, a 40-year-old psychology graduate, looked at the smoking edict as an opportunity. He first picked up cigarettes as a teenager and over the next quarter-century walked away from them twice, but never for good.

He has heard some at the hospital complain about feeling more alienated. But in his office in behavioral health services, Carroll feels "mostly just liberated." Between the free cessation classes, a nicotine patch, medication and aggressive exercise, he's about to pass the four-week mark.

"I'm doing all of it, everything the research says leads to a good outcome," he said. "Forty-one is going to look good."