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Employee Attitudes and Smoking Behavior at the City of Hope National Medical Center Smoke-Free Campus

David Lin, Douglas C. Stahl, David Iklé, and Frederic W. Grannis Jr

Since 1989, City of Hope National Medical Center (COH), located in Duarte, California, and a member of the National Comprehensive Cancer Network, has prohibited smoking anywhere on the 100-acre campus. Because little published information is available on smoke-free campuses (SFCs), we investigated the attitudes of COH employees toward the SFC and attempted to answer the question of whether a difference in employee smoking behavior occurred and was attributable to the SFC policy. An anonymous survey was sent to all 2787 campus employees using both Web-based data entry and scannable paper forms. Employees with network access were contacted by e-mail and those without computers were contacted in person. Respondents were asked questions regarding their attitudes toward the SFC and about their smoking history and current smoking behavior. A total of 1356 responses (48.7%) were received. One hundred (7.4%) respondents were current smokers, 242 (17.8%) were ex-smokers, and 1014 (74.8%) were nonsmokers. Smokers and ex-smokers smoked a mean of 2.4 fewer cigarettes (95% CI, 1.8 to 3.1; P < .0001) on workdays than on days off, with evidence of a small amount of compensatory smoking (one cigarette per day). Of the smoking employees, 61.6% believed that the SFC reduced their cigarette consumption, and 42.2% quit smoking while employed at COH between 1989 and 2002. Of all respondents, 92.6% supported the COH SFC policy. High acceptance was consistent across gender, ethnicity, job type, and educational level. COH's SFC policy is strongly supported by employees and may decrease cigarette consumption and facilitate smoking cessation among smoking employees. This information may be useful to NCCN and other medical centers in assessing current and planning future campus smoking policies.