部分控烟立法城市依法建设无烟医院问题分析

Survey on the enforcement and practice of smoke-free policy in hospitals and its related factors

目的了解我国控烟立法城市医疗卫生场所执法状况,分析相关原因,有针对性的提出建议。方法选取天津、广州、杭州、上海、哈尔滨5个城市,采用随机抽样方法,共抽取37所二级及以上综合性医院为研究对象。通过现场观察和个人访谈获得医院内无烟环境相关信息。结果禁烟标识张贴率门诊大厅最高100.00%(37/37)、其次是门诊候诊区91.89%(34/37),门诊诊室张贴率最低27.03%(10/37);控烟宣传栏设置率为27.03%(10/37),45.95%(17/37)医院免费为就诊者提供控烟宣传资料。37所医院均未见烟草广告,5.41%(2/37)医院内的零售店销售机制卷烟;72.97%(27/37)医院设置了室外吸烟区,24.32%(9/37)医院设立有控烟巡视员。病房楼梯间是发现烟头最高的地方(48.65%),其次是门诊楼梯间(35.14%),仅有门诊室内和病房内未见烟头。结论医院需要进一步加强有关无烟医疗卫生机构的培训及宣传工作,执法部门应采用多种办法加强医疗卫生机构的控烟执法工作。建议加强无烟环境布置;加强医院内控烟执法力度,鼓励公众利用热线进行投诉举报;开展有效的媒体传播宣传活动;促进医疗卫生机构开展戒烟门诊等相关服务;重点场所可以使用相关技术手段。

Objective To understand the enforcement and practice of smoke-free policy in hospitals and analyze its related factors. Methods A total of 37 secondary and above level hospitals were selected using random sampling method from five cities in Tianjin, Gunagzhou, Hangzhou, Shanghai and Haerbin with implementation of tobacco control legislation.Information about smoke-free environment in the hospitals was obtained through field observation and personal interview. Results The posting rate of no-smoking signs was the highest of 100.00% in the lobbies of out-patient building(37/37), followed by 91.89%(34/37) in the out-patient waiting areas and the lowest of 27.03%(10/37) in the out-patient clinics.17 out of 37 hospitals had specific billboards for tobacco control and 17 hospitals provided free materials of tobacco control to patients.There were no tobacco advertisements in all 37 hospitals, but cigarettes were still sold in the shops of 2 hospitals.The outdoor smoking areas were assigned in 27 hospitals, and only 9 hospitals had tobacco control inspectors.The cigarette butts were found in the stairwells of inpatient buildings(48.65%) and outpatient buildings(35.14%), none was found inside both outpatient and inpatients rooms. Conclusions Smoke-free training and education should be strengthened in hospitals.The law enforcement departments should adopt various methods to strengthen tobacco control in medical and health institutions in order to have smoke-free environment.It is suggested to encourage the public to use the hotline to report complaints.