Health Policy Analysis

Introduction

Tobacco usage takes millions of lives annually worldwide with 488,000 deaths annually in the US alone. The healthcare cost of tobacco usage is estimated at $300 billion dollars annually (Dennis 2015). The number of smokers in the world are expected to rise to 1.8 billion by 2020(who.int). Although people know the health risks of this highly addictive habit, they still choose to smoke. However, not only the smokers are exposed to the dangerous health risks and the people around them are also paying the price.

Tobacco smoke affects everyone near a smoker both in public and in enclosed spaces.

A person resides in two environments, home and the workplace, that affect the individual’s health. Most people spend the majority of their time at work estimating 40-50 hours a week. Therefore, the work place is an important environment that should be safeguarded for the health of the workers. Healthcare facilities have a particularly sensitive environment which should be protected for the health of the patients as well as healthcare workers.

Due to the amount of time patients and health workers they spend in the hospitals, smoke in the environment can affect their health.

Workplaces are made of diverse cultures which include both smokers and nonsmokers. Creating a healthy environment to cater for this diversity is challenging for some employers especially when the preference of one group affects the other such as smokers and non-smokers. However, management has the responsibility to create a healthy workplace environment by enforcing the polices that ensures a safe environment for everyone.

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Change of tobacco-free workplace has increased the adoption of health policies prohibiting the use of tobacco products in and around healthcare organizations. Many of the healthcare organizations seek to promote a clean and healthy image to the public and have recognized the adoption of the tobacco-free hospital policy as a way to show off this health commitment. Hospitals have adopted policies banning tobacco use in the workplace over the last few years and has become a nationwide trend. Various kinds of resources are developed and initated in healthcare facilites to assist in implementing the tobacco-free policies. The organizations are responsible for maintaining and enforcing these policies to ensure a clean environment and protect the health of their patients and employees.

Policy Analysis

The tobacco-free policy aims at preventing the use of tobacco by employees and patrons within the area of a healthcare organization (Kim, 2009). An organization that implements this policy wants to present a clean environment to the public who are the primary beneficiaries of its services.

While applying the policy, several strategies are implemented to ensure the smooth transition of the policy in the organization. The policy is approached as an initiative for improving health by incorporating it into the wellness planning of employees to prevent those who smoke from being stigmatized or feel targeted. Collaborating with the community around the healthcare organization is essential to bolstering the policy. A task force is formed to enforce the policy in the organization. Penalties are developed for people caught violating the policy which may include expelling them out of the premises or firing employees.

The tobacco-free policy must be reviewed regularly and modified if necessary due to the implementation of new legislation. The policy can range from few restrictions to completely banning of smoking. When the policies were first implemented, it involved creating segregated areas in the workplace for smokers and non-smokers. It required the two groups having different workstations and office space which are ideal for some organizations but difficult to implement for some especially where employees cooperate in various tasks. The tobacco was not eliminated and could still affect the non-smokers though minimally. It is not also effective to separate work colleagues which can affect the productivity.

To create a smoke-free environment, the policy can prevent smoking in the premises of the organization but allow smoking in designated outdoor areas. The policy can also allow a designated area for smoking which is well ventilated.

The policy reduces or eliminates tobacco smoke in the environment by controlling the source of the smoke; that is the smokers. The policy should involve employees whose support is essential for the implementation of the policy. Before the policy is implemented, the discussion takes place among the employees and the management to clarify any issues that may arise and define transition steps for the policy. Once the discussion has taken place, the organization can implement the policy and keep the employees informed on every stage of the policy transition. After the transition is completed, the smoking ban can be enforced in the organization. After implementing the policy, it is essential for the organization to ensure that no one is given privilege among smokers despite his or her position in the company to prevent resentment or disputes from arising.

Issues Addressed by the Policy

Smoking is a major health problem in healthcare organizations as it has impacts on the health of the smokers and non-smokers especially healthcare professionals and patients. It is the responsibility of the healthcare organizations to provide a safe and clean environment for everyone within the premises of the organization.

The policy addresses the issue of the healthy environment within the organizations. Tobacco smoke creates an unsafe environment for providing health services. It affects the health workers and patients whose conditions such as asthma may be aggravated by the smoke (Bloor, 2006). Via the policy, an organization anticipates changing the environment to be smoke-free and conducive for everyone operating there.

The policy seeks to address safety issues in the organization. Research indicates that a significant number of fires in the workplace are started by discarded cigarettes which cost an organization a lot due to property damage or loss of life. It is expected that maintenance expenses incurred due to smoke in the environment will be reduced.

The policy also seeks to increase the morale of employees especially non-smokers affected by the smoky environment. It also aims to address legal costs incurred by an organization when it is sued over the smoky environment that affects the employees.

History of the Legislation

There are state laws in America that regulate smoking in the workplace. These laws were formed after research indicated exposure to tobacco smoke to non-smokers via passive smoking. The aim of the legislation to protect the health of employees. Employees with health conditions that can affect by smoking are protected under the American with Disabilities Act enacted in 1990. Employers are prohibited by the Act from discriminating against employees with disabilities. In a situation where tobacco smoke is involved, employees can request for a smoke-free workplace.

Effectiveness of the Legislation in Addressing the Issues

The tobacco-free policy has changed immensely the organizations where it has been implemented. It mostly covers indoor setting of organizations though it sometimes applied to outdoor as well. When the policy is enacted in healthcare organizations, the health and safety of the patients, employees and the community is protected from tobacco smoke. The policy reduces the exposure of the people in the organization to second-hand or passive smoke which can affect their health. It creates a safe and healthy environment in the workplace where healthcare professionals can work well without interference from smoke (Juster, 2007).

The policy supports local groups in the community who use or visit the healthcare organization to promote healthy lifestyles, i.e. spread awareness of the tobacco-free campaign. With the policy in place, cigarette litter common with smokers is reduced hence the chances of it being ingested by children or pets is eliminated. Maintenance costs in the organizations are reduced as cigarette litter and smoke is removed from the facilities and office equipment such as carpets, furniture, etc. last longer.

Tobacco-use policy reduces the risk of fires in the organization which are mainly caused by matches or cigarette litter hence increasing safety for the people within the premises. By promoting a smoke-free environment, employees or people who are smokers are encouraged to quit smoking and enhances support for those who are trying to quit or have recently quitted.

Smoke-free workplaces not only reduce health issues from the tobacco smoke but improve the productivity of the workers (Farzadfar et al., 2013). Smoky environments reduce productivity in the workplace due to absenteeism of employees with smoke-related illnesses. Loss of productivity in an organization is also contributed by smoke breaks taken by employees resulting in inefficiency. Non-workers have to work harder to compensate for this work gap caused by the incompetence of the smokers. The policy assists in increasing productivity at the workplace by preventing smoke breaks and reducing disputes in the workplaces that may occur between smokers and non-smokers over unbalanced work load. It also lowers absenteeism of employees due to smoking related illnesses.

Studies show that a majority of workers both smokers and non-smokers prefer working in a smoke-free environment. The tobacco-free policy promotes a smoke-free and safe environment conducive for the employees. In such an environment, the health of employees is protected and there is an improvement in the morale and the overall job performance.

An organization with a tobacco-use policy in place eliminates legal costs that arise due to patients or employees suing the organization about the smoke in the environment which reduces direct healthcare expenses incurred. The employees may negotiate for a lower health, life and disability coverage as tobacco use is cut in the organizations.

A well-defined policy that includes penalties for violations relieves the management the task of dealing with tobacco use in the premises on their own. It creates a positive image of the healthcare organization to the public by showing that the organization cares about the health of their employees and patients.

People Most Affected by the Problem

Smoking affects various people, smokers and non-smokers alike. Smokers are directly affected by tobacco use as it affects their health which makes them likely to get ill resulting to absenteeism in the workplace. It can cause lung cancer, heart disease and respiratory illnesses in smokers (US Department of Health and Human Services, 2014).

Non-smokers are mainly affected by second-hand smoke especially those who live or work with smokers. Second-hand smoke has a combination of tobacco smoke from the cigarette and the breath of the smoker and is dangerous to human health in any amount. Research has indicated that second-hand smoke results in the death of thousands of non-smokers and might play a role in the development of lung cancer (Chambrone et al., 2013)

However, children are the most vulnerable group of non-smokers. Children who live in homes where they are regularly exposed to secondhand smoke are likely to suffer respiratory attacks and other infections at an elevated rate. The second-hand smoke is known to worsen asthma attacks, result in bronchitis or pneumonia and increase the rate of ear infections in children.

Secondhand smoke also affects pregnant women and the fetuses. Pregnant women exposed to the second-hand smoke are more likely to have miscarriages or stillbirths, babies with impaired lungs or deliver sick babies with low weight.

Patients exposed to second-hand smoke in healthcare organizations have a high risk of suffering from respiratory diseases. The smoke may worsen health conditions for patients with respiratory illnesses such as asthma, bronchitis, etc. which may result in the death of patients (Jha & Peto, 2014).

Future of This Legislation

Adoption of tobacco-use policy in various industries is set to continue as authority and people seek safer environments in which they can live and operate in. Recent proposals made involve implementing this policy for multi-unit housing where landlords and tenants suffer health consequences from smoke that drifts into their unit from units occupied by smokers. Smoke-free apartments have been proposed to protect the health of all the stakeholders.

WHO and other health organizations have called for more measures to be put in place to protect non-smokers against exposure to second-hand tobacco smoke. Many countries have participated and continue to participate in the discussion of initiatives that seek to promote smoke-free places where everyone can benefit. These efforts are expected to inspire policy makers and employers to enact tobacco-free policies that will create workspaces and an environment free from the smoke with the aim of increasing productivity, reduce smoke-related illnesses.

Increasing awareness campaigns from organizations and communities around the world on the consequences of tobacco smoke is expected to increase the number of organizations and employers implementing a tobacco-free policy to make workplaces smoke-free.

References

  1. Bloor, R. N., Meeson, L., & Crome, I. B. (2006). The effects of a non‐smoking policy on nursing staff smoking behavior and attitudes in a psychiatric hospital. Journal of psychiatric and mental health nursing, 13(2), 188-196.
  2. Chambrone, L., Preshaw, P. M., Rosa, E. F., Heasman, P. A., Romito, G. A., Pannuti, C. M., & Tu, Y. K. (2013). Effects of smoking cessation on the outcomes of non‐surgical periodontal therapy: a systematic review and individual patient data meta‐analysis. Journal of Clinical Periodontology,40(6), 607-615.
  3. Farzadfar, F., Danaei, G., Namdaritabar, H., Rajaratnam, J. K., Marcus, J. R., Khosravi, A., … & Ezzati, M. (2013). National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment. The Lancet, 381, S47.
  4. Jha, P., & Peto, R. (2014). Global effects of smoking, of quitting, and of taxing tobacco. New England Journal of Medicine, 370(1), 60-68.
  5. Juster, H. R., Loomis, B. R., Hinman, T. M., Farrelly, M. C., Hyland, A., Bauer, U. E., & Birkhead, G. S. (2007). Declines in hospital admissions for acute myocardial infarction in New York state after implementation of a comprehensive smoking ban. American Journal of Public Health, 97(11), 2035-2039.
  6. Kim, B. (2009). Workplace smoking ban policy and smoking behavior. J Prev Med Public Health, 42(5), 293-297. http://www.who.int/tobacco/en/atlas38.pdf
  7. US Department of Health and Human Services. (2014). The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health,17.

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Health Policy Analysis. (2021, Mar 06). Retrieved from http://studymoose.com/health-policy-analysis-essay

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