Centers that ban cigarettes run risk of deterring clients

Many hospitals and other health-care offices have banned cigarettes inside and out. Employees and visitors might grumble, but for the most part, they understand that the move makes sense.

The issue gets more complex if the nonsmoking building is a center that treats other addictions. Anyone who works with alcoholics and drug users can tell you that smoking usually goes hand in hand.

But it can be more difficult to keep people in long-term treatment for drug and alcohol addiction if they aren’t allowed to smoke, according to a recent study by researchers at Ohio State University and Amethyst Inc., a Columbus treatment center.

The study looked at data from the first Ohio center to prohibit tobacco, before and after its 2003 ban. The center, which is not in central Ohio and remains smoke-free, is unnamed, per the request of officials there.

Thomas Gregoire, a professor of social work at Ohio State, and Gretchen Clark Hammond, who works at Amethyst, compared 147 women admitted before the ban and 214 women treated after.

The center had a 70 percent success rate before the ban. That dropped to 42percent by the end of the first three months under the ban. After the ban, patients stayed an average of 13 fewer days.

“That’s the challenge, and it’s juxtaposed against the importance of” getting people to quit, Gregoire said.

The researchers say that things have changed significantly in the eight years since that center’s ban.

Amethyst has been smoke-free for about five years, and experience has shown Hammond that making the transition not only is doable, but also is a step that will ensure better success for those in recovery, she said.

At least eight in 10 people in inpatient treatment smoke, Hammond said. Removing smoking as a trigger for other cravings makes it more likely that an addict won’t relapse, she said.

“There’s brain science behind that, and there’s a lot of behavioral science behind that.”

More centers are adopting tobacco bans, and some states have mandated them at treatment facilities.

But in practice, many administrators remain reluctant.

“We have studied and studied and studied this to death. We have voted and voted and voted again,” said Jann Robinson, director of nursing and patient safety at the Betty Ford Center in California.

Even in a state that has been a front-runner in restricting smoking in this country, Betty Ford officials have yet to ban cigarettes on the grounds. They do offer smoking cessation after a patient’s initial detoxification, and about 70 percent of smokers try to quit, Robinson said.

“We would really like to go smoke-free. That is someday our goal,” she said.

The lingering concern: “We would not have as many people coming in our front door. It would lower people’s access to treatment.”

Paul H. Coleman, president and CEO of Maryhaven in Columbus, said his experience with trying a smoke-free environment at a women’s center on the Far East Side was disappointing. The experiment two years ago lasted about six months.

“We listened to our patients’ voice, and it was very loud and very clear, and this is essentially what they said: ‘We signed on agreeing to stop the use of alcohol or other drugs. … We did not sign on to stop smoking, and we don’t want to do it.'”

Coleman said that the behavioral-health community needs more resources to help patients stop smoking.

He said he hopes that Maryhaven will try a smoke-free campus again someday.

By Misti Crane
THE COLUMBUS DISPATCH
mcrane@dispatch.com

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