Smoke-free hospitals in Poland – a cross-sectional survey
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Department of Cardiology, Faculty of Medicine, College of Medicine, University of Warmia and Masuria, Olsztyn, Poland
Polish Hospital Federation, Warsaw, Poland
School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
Department of Human Capital Management, Cracow University of Economics, Krakow, Poland
Department of Psychology and Social Sciences in Medicine, Faculty of Medicine, College of Medicine, University of Warmia and Masuria, Olsztyn, Poland
National Cancer Institute, Bethesda, MD, USA
Submission date: 2019-10-24
Final revision date: 2020-01-03
Acceptance date: 2020-01-03
Online publication date: 2020-06-11
In 2010, the government of Poland passed an amended smoke-free law that strengthened existing tobacco control policies and banned smoking in hospitals. The aims of our study are: to determine the state of smoke-free practices in Polish hospitals, and to identify challenges facing hospitals implementing smoke-free practices.

Material and methods:
In 2018, a cross-sectional survey was conducted on a representative sample of 100 hospitals operating in Poland. The research tool was the ENSH-Global Self-Audit Questionnaire. The questionnaire included 48 items related to the various aspects of smoke-free policy implementation in the hospital.

Among the surveyed hospitals, public entities were the dominant group (79%). The mean score for all analyzed standards was 78.55 points (out of 144 maximum available), with no differences (p = 0.4) between public and private entities. All hospitals surveyed displayed signage with information about prohibited tobacco products and tobacco-free campus boundaries. Hospital staff (95%) and service users (98%) reported a basic level of understanding of the hospital’s tobacco-free policy and the available tobacco cessation services. However, tobacco-free policies, in line with the ENSH-Global Standards, were implemented in 61% of surveyed hospitals. More than half of the hospitals (64%) do not currently assess tobacco use or provide tobacco dependence treatment services.

Overall, smoke-free policies in hospitals operating in Poland are compliant with the National Tobacco Control Act and provide a smoke-free environment for service users and staff. However, continued monitoring and evaluation of tobacco control activities are necessary to promote the importance of smoke-free environments.