In an example of the law of unintended consequences, a recent study found that hospital smoke-free bans may be endangering the well-being of patients. The study, conducted by the Psychosocial Oncology and Cancer Nursing Research Group at St. Boniface Hospital Research Centre, Winnipeg, Canada, recently documented dangerous conditions that resulted when patients defied the smoking ban when hospitalized.
The study found incidences of wheelchair patients being accidentally locked out of the hospital on cold winter nights, patients dragging their IVs outside through the snow, IVs becoming frozen, and electronic equipment malfunctioning because of the cold temperatures.
The researchers’ study was based on interviews of nursing staff, patients and hospital workers at Winnipeg’s Health Sciences Centre and the University of Alberta Hospital in Edmonton and was published in the Canadian Medical Association Journal. The study concluded that not enough support is provided to smokers to manage withdrawal symptoms while they are hospitalized. As a result, patients are left to their own devices.
Hospital staff said patients would constantly ask to be taken outside. Patients maintained that they didn’t want to go outside alone to smoke because they were afraid they would get sick while outside. Those that did risked getting frostbite. Guards told of patients who were “pushing this IV pole all the way down the sidewalk in the snow” after they were told they couldn’t smoke on hospital grounds. One wheelchair patient was locked outside on a winter night because he couldn’t see the sign saying the doors lock after certain hours. The sign, placed at eye level, was too high for him to see.
Another dangerous scenario documented by the researchers was of patients in isolation due to infection smoking outside, then tossing their used cigarette butts on the ground. The discarded butts could potentially spread disease if picked up and smoked by another person desperately wanting a smoke.
Additionally, hospital smoking bans disrupted nursing care when patients took smoke breaks, leaving nurses with no idea when they would return. Some nurses were understanding, others weren’t. Because smoking is considered a habit rather than an addiction, healthcare providers are not always sympathetic and may have a hard time understanding why a patient with a serious medical problem would continue smoking.
“I have zero understanding on the drive to make a person get out of there, have that cigarette when they’re obviously having pain,” said one healthcare worker. Another hospital employee was more sympathetic. “We need to address these people, because it is a stressful time to give up your bad habit.”
The researchers reported that although some patients managed to go cold turkey during their hospital stay, they had to do so with very little to no support.