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General Information
Q. What is Saskatoon Health Region’s Tobacco and Smoke-free Policy?
A. Smoking or use of other tobacco products is not permitted in Saskatoon Health Region buildings or on the grounds 24 hours per day. This policy went into effect for physicians, staff, students, volunteers and other service providers September 1, 2006. There are two exemptions: tobacco used for cultural and ceremonial purposes and designated smoking areas for Special Care Homes.
Q. Why is Saskatoon Health Region doing this?
A. These changes to our Tobacco and Smoke-free Policy support our strategic vision of “Healthiest people, healthiest communities, exceptional service.” We want to denormalize tobacco use and strengthen our position as leaders of health and wellness in this province. Tobacco use is the leading cause of preventable disease, disability and death in this country. As a Health Region, we have a responsibility to be role models by developing and supporting policies and actions in the best interest of health. Evidence has shown there is a direct link between smoking restrictions and smoking behaviour, with less people smoking in areas with strong smoking policies. In a recent survey, 82% of Saskatchewan residents indicated support for smoke-free perimeters for health-care facilities.
Q. What services and benefits are available?
A. The following services are available:
- access to Nicotine Replacement Therapy (NRT), at no cost, for clients admitted to hospital or residential care for the duration of their stay;
- one-time access to NRT, at no cost, for up to a 10-week program for residents in Special Care Homes;
- brief three- to five-minute tobacco cessation counselling and policy communication integrated into nursing practice in acute and special care facilities; and
- access to an Addictions Counsellor to provide consultative support, education and one-on-one or group counselling for employees, clients and the public.
Q. Why are Special Care Home residents allowed to continue smoking?
A. Saskatoon Health Region is greatly concerned about the health of residents who use tobacco products, but we also recognize a Special Care Home is a resident’s home. Under the Tobacco Control Act, Special Care Homes are permitted to allow smoking in a room separately ventilated from the rest of the facility. Within this Health Region, we currently have two Special Care Homes with ventilated rooms. Our policy prohibits the construction of any new/additional ventilated rooms. As a result, residents will be permitted to smoke in a designated outdoor location 24 hours per day or within a ventilated room, if available. There are several Special Care Homes that have already implemented a 100% smoke-free policy. We will continue to educate residents about the dangers of tobacco use and smoking cessation services available. This exemption will be reviewed in the future.
Q. Can employees and visitors at Special Care Homes continue to smoke in the designated smoking locations?
A. The Special Care Home exemption applies to residents only. This means all employees and visitors are required to move off property to smoke or use tobacco products, even if the facility provides a ventilated smoking room or designated outdoor area on the property.
Q. Why don’t palliative care and mental health inpatients, clients at Calder Centre and Brief/Social Detox Centre, or long-term care residents in an acute care facility have an exemption as well?
A. Continuing to support these exemptions would be inappropriate for Saskatoon Health Region because we would be assisting the people under our care to engage in what we know to be unhealthy behaviour. Although we recognize these changes may be difficult for long-term care residents in acute care facilities, our position is that a Special Care Home is a resident’s home, while an acute care facility is not designed to be a permanent residence.
Q. Does this policy apply to all Saskatoon Health Region property, including rural properties, affiliates or leased buildings? What about my doctor’s office?
A. The policy includes ALL Health Region buildings and grounds, including affiliates and regardless of location. In buildings leased by the Health Region, it is up to the building owner to determine if smoking will be permitted on the property. However, the Health Region expects staff who work in a leased building to be role models and to support our policy by moving off property.
Q. Where are the property boundaries?
A. Facility boundaries differ from location to location. Boundary maps are available for the three acute care facilities within Saskatoon, which see the highest volumes of staff, patients/clients/residents and visitors. These maps are available at the reception area located at each of the three hospitals within Saskatoon. If you are visiting a Saskatoon Health Region facility and want to know more about boundaries, contact the Tobacco-free Helpline at (306) 655-4685.
Q. Can I smoke in my vehicle?
A. People can smoke in their private vehicles while parked on our property. This provision will be reviewed at a later date. We strongly discourage this behaviour due to the risks of exposure to second-hand smoke in confined spaces Smoking in private vehicles in underground parkades is not permitted. Smoking in all Health Region-owned/funded vehicles is prohibited.
Q. What will this mean for people coming to Health Region facilities?
A. Visitors, patients and clients will be required to comply with the policy. Visitors are asked to leave the grounds when using any tobacco product. All patients and residents, upon admission to a facility, will be informed of the policy and asked if they use tobacco. Patients and residents interested in quitting or refraining from using tobacco can talk to their nurse about accessing NRT, which will be provided to them at no cost for the duration of their hospital stay to help manage their nicotine dependence. One-time access to NRT will be available to residents in long-term care. All patients and clients will also have access to the Health Region’s Tobacco Cessation Services Counsellor who can assist them in quitting. An individual’s quitting success rate doubles when using NRT. When combining NRT and counselling, the success rate doubles once again.
Q. What does this mean for tobacco users staying at a residential facility, such as Social/Brief Detox Centre?
A. Clients at Social/Brief Detox will be assessed for and, if appropriate, be provided with NRT upon admission to detox. Staff, visitors, patients and clients are all required to respect the policy.
Q. What if I use spit tobacco?
A. The smoking policy applies to the use of all tobacco products including spit tobacco. The use of spit tobacco (snuff/chewing tobacco) represents a significant health risk and is not a safe substitute for smoking. Here are some facts you and your client should know about using spit tobacco:
- Spit tobacco is made from a mixture of tobacco, nicotine, abrasives, sweeteners and salts. It contains over 4,000 chemicals including 28 known carcinogens.
- Nicotine is the main ingredient in spit tobacco and users become addicted just as they would to smoking cigarettes.
- The amount of nicotine in one dip or chew of spit tobacco can deliver up to five times the amount found in one cigarette.
- Spit tobacco users are 50 times more likely than non-users to contract cancers of the cheek, gums and inner surface of the lips. Spit tobacco can also cause cancers of the oesophagus, larynx, stomach, pancreas and prostate.
- Spit tobacco contributes to tooth decay, gum disease and tooth loss, and users are at risk for heart disease, hypertension and heart attacks. (Source: Oral Health America 2001)
Q. How will patients/clients who use medicinal marijuana be affected by this policy?
A. The Medical Advisory Committee reviewed this issue and has decided medicinal marijuana will follow the Tobacco and Smoke-free Policy and will not be permitted in Health Region buildings or on the grounds.
Policy Enforcement
Q. How is this policy enforced?
A. Non-Compliance/Breach. Non-compliance with this policy is a serious offense and may be subject to a range of disciplinary sanctions including termination of employment or of the business relationship, suspension of privileges and/or of services.
Q. I recieve services in my home. Since this is my home, can't I smoke if I want?
A. As an employer, Saskatoon Health Region has a responsibility to protect our employees from the harmful effects of exposure to second-hand smoke. We ask that when our employees are providing a service in your home that you refrain from smoking at least one hour prior to the visit.
Access to Benefits and Services
Q. What types of NRT will be funded by the Health Region’s smoking cessation program?
A. Saskatoon Health Region feels success will be increased by providing people with a variety of NRT options such as the nicotine gum and patch, which are covered under this program. Nicotine inhalers may be covered under special circumstances. Providing options encourages those who may have experienced past difficulties in finding a suitable tobacco cessation aide. All options are most successful when combined with a tobacco cessation program that discusses stress management, weight control, effects of social pressure and tips for resisting the temptation to light up again, which is offered through the Addictions Counsellor.
Q. Will the Health Region pay for patients to access additional smoking cessation services, such as hypnosis, acupuncture, Reiki, etc.?
A. The Health Region is unable to assist with alternative tobacco cessation services, such as hypnosis, acupuncture, Reiki, etc. If you have health insurance, you should contact your insurance provider to see if these services are covered. Alternative therapies should be chosen with care as not all have been well-studied and can be expensive. Some people do find success using these alternative methods but if you are unsure about a specific product or service, consult with your physician or pharmacist. The Health Region will only cover the cost of NRT for patients/clients/residents admitted to one of our acute care or residential facilities for the duration of their stay. Residents in a long-term care facility will have one-time access to free NRT.
Q. How can I access NRT?
A. Patients/clients/residents can talk to their nurse upon admission to any acute care or residential facility. Visitors can access NRT any time at their own expense. The patch, gum and inhaler are available for purchase over the counter from any pharmacy or retail outlet. It is advisable to consult with your physician or pharmacist prior to using NRT products. If you have health insurance, contact your provider about NRT coverage.
Q. How will nurses provide brief smoking cessation counselling in acute care facilities?
A. All patients are asked about their tobacco use status and informed of the Tobacco and Smoke-free Policy upon admission to an acute care or residential facility. Nurses provide patients who smoke with a brief three- to five-minute assessment and counselling session. This entails exploring their tobacco behaviour and providing print resources based on their readiness to quit. Access to NRT and referral to an addictions counsellor for continued support in hospital or community is offered.
Q. What if my nurse does not offer brief smoking cessation counselling in my acute care facility?
A. Make your nurse aware of your interest in quitting tobacco or accessing NRT so that she can assist you. You can also contact the Tobaccofree Helpline (306) 655-4685.
Q. How many times can I access NRT at the Region’s expense?
A. This service can be accessed on each occasion of admission to an acute care facility. In residential facilities, clients have access to NRT for up to one, 10-week program. Staff have one-time access to NRT.
Q. I’m coming in for day surgery, can I still access free NRT?
A. Access to free NRT is available for patients admitted to a facility for an overnight stay or longer. We encourage smokers who are coming for day surgery to refrain from smoking before and after surgery.
Q. If I am a patient/client, can my family access free NRT to better ensure my success upon returning home?
A. Having the proper support systems in place is a crucial part of successfully quitting. Family members interested in quitting can access NRT at their own expense. However, all family members have free access to tobacco cessation counselling services, which will increase their rate of success as well as teach them how to effectively support one another. For more information on counselling services, contact Addiction Services (306) 655-4100 (rural clients may call collect). You can find out more about NRT by contacting the Tobaccofree Helpline (306) 655-4685 or by visiting the Saskatoon Health Region website at www.saskatoonhealthregion.ca. Family members are also encouraged to contact their individual insurance providers about their NRT plans, if applicable.
Concerns
Q. If I have concerns about the policy, who can I contact?
A. If you have concerns, questions or comments about the policy, contact the Tobaccofree Helpline (306) 655-4685. If you have questions about NRT and counselling services, contact Addiction Services (306) 655-4100 (rural clients may call collect). Additional information can also be found on the Tobacco and Smoke-free website at www.saskatoonhealthregion.ca or by sending us an e-mail at tobaccofree@saskatoonhealthregion.ca.
Q. If smoking is no longer permitted on the property, why are some sites continuing to be exposed to secondhand smoke?
A. Every facility is designed differently and some may be located near public sidewalks or property not funded/operated by the Health Region. Although we have changed our smoking policies, our neighbours have not. We understand this may be disheartening to people who have to access these locations. We are reviewing a variety of options including: removing tobacco waste disposals altogether and moving others to lower frequency traffic areas, as well as entering into discussions with our neighbours about their smoking policies.
Q. Isn’t the Region concerned about the public image of having smokers congregating off property to smoke?
A. People smoking along the property perimeters is not an ideal scenario. This is a big change and we want to make this transition as easy as possible. Providing designated smoking areas on the grounds or cigarette disposal units near these areas sends a mixed message and weakens our ability to denormalize tobacco use. We feel prohibiting smoking on the property sends a stronger message about our commitment to health and wellness, our desire to support healthy lifestyle choices and our vision of “healthiest people, healthiest communities, exceptional service.”
Q. What if I want to continue using tobacco products when visiting or receiving care at a Health Region facility?
A. We urge tobacco users to refrain from using tobacco products while visiting or receiving care at one of our facilities. We encourage all patients to remain on property while under our care. If you are a patient and choose to use tobacco products while receiving care, you will be required to sign a waiver to go off property. We encourage everyone to be accountable for their personal safety, including exercising caution and being aware of the surroundings when leaving the grounds. Currently, we are not prohibiting people from smoking in their vehicles, although we strongly discourage this due to the risks of exposure to second-hand smoke in confined spaces.
Q. Isn’t the Health Region discriminating against tobacco users with this policy?
A. Legally, Saskatoon Health Region has a right to decide whether or not to permit tobacco in its facilities and on its grounds. As a health-care facility, we have a responsibility to create and support policies and actions in the best interest of health for all people within the Region. Tobacco use is the leading cause of death and preventable disease in this country, and we are uncomfortable assisting people to engage in what we know to be unhealthy behaviour. We also recognize smoking and using tobacco products is a powerful addiction and that many people, if given the choice and proper support systems, would choose to be tobacco and smoke-free. This is why Saskatoon Health Region has created tobacco cessation options. We are interested in increasing the success rates for those interested in quitting. For those who choose to continue smoking, we are simply demonstrating our commitment to healthy living by creating a tobacco-free environment.
Policy Implementation and Ongoing Monitoring
Q. Isn’t outside pollution worse than tobacco smoke?
A. This is a myth. Contrary to public perception, fine particulate matter pollution from cigarettes is actually 10 times higher than diesel vehicle exhaust. The particulate matter from smoking three cigarettes is equal to the exhaust emitted by a diesel vehicle that has been running for 30 minutes inside a garage.
Q. What will be done with tobacco waste?
A. The Health Region is dedicating additional resources to assist Facility Services with the cleaning of our grounds and the property perimeters at the three acute care facilities in Saskatoon, where we see the highest volumes of staff, patients and visitors. We believe the elimination of cigarette waste sends a clear message about our desire for a tobacco-free environment. We will also remind tobacco users to be respectful of the environment and our neighbours in disposing of their tobacco waste.
Q. How can I best support the policy?
A. We all have a role to play in creating healthier communities. You can best support this policy simply by moving off property when using tobacco products. We have asked our employees to take an active role in making people aware by politely asking tobacco users to move off property. Staff have been advised to neither provide nor accept tobacco products to/from people under our care, unless it is for ceremonial purposes. Any other situations will be reviewed on a case-by-case basis. Non-smokers can help by respecting this may be difficult for tobacco users and by providing encouragement to those who choose to quit, while continuing to respect the right to choose.
Informational Resources
Q. Where can I get more information about the policy and tobacco cessation services?
A. You can call Addiction Services (306) 655-4100 (rural clients may call collect). There is also a pamphlet, “Are You Thinking About Quitting Smoking or Other Tobacco Products?,” which is available (in English and French) by calling the Tobaccofree Helpline (306) 655-4685 or by downloading from our website at www.saskatoonhealthregion.ca. You can also e-mail us at tobaccofree@saskatoonhealthregion.ca.
Staff Only
Staff can access employee-specific questions and answers through the Health Region's Tobacco and Smoke-free intranet site on the Infonet.
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