Tobacco & Smoke-Free Policy Questions & Answers

Transcription

1 Tobacco & Smoke-Free Policy Questions & Answers General Information Q. What is Prairie North Health Region s Tobacco and Smoke-Free Policy? A. Effective January 18, 2012, smoking or use of other tobacco products is not permitted on Prairie North Health Region property. This includes all buildings, grounds, parking lots, and vehicles owned or operated by the Health Region. Q. Why is Prairie North Health Region implementing this policy? A. Prairie North Health Region s Tobacco and Smoke-Free Policy supports our vision of Healthy People. Healthy Communities. As a health region, we have a responsibility to provide a safe environment for patients and a safe workplace for our employees. We have a responsibility to develop and support policies and actions in the best interest of everyone s health. We want to continue to reduce and de-normalize smoking and tobacco use, and strengthen our leadership in improving the health and wellness of people in our province. Tobacco use is the leading cause of preventable disease, disability and death in Canada. Evidence has shown a direct link between smoking restrictions and smoking behaviour, with fewer people smoking in areas that have strong no-smoking policies. Prairie North Health Region is among several Saskatchewan health regions that have implemented or are implementing Tobacco and Smoke-Free Policies. Q. What does this mean for people coming to Prairie North Health Region facilities for care and service, and for people working in PNHR facilities? Who does the policy apply to? A. The policy applies to everyone coming onto Prairie North Health Region property and everyone within Prairie North Health Region facilities and sites. Everyone includes patients/clients, staff, physicians, volunteers, visitors, students/trainees, contractors, and all others. People are expected not to smoke or use tobacco anywhere on PNHR grounds. Visitors are asked to leave the grounds if they choose to smoke or use tobacco products. Supports are available for patients, residents and clients admitted to PNHR facilities and interested in reducing or quitting smoking or the use of tobacco. Prairie North employees and physicians also have access to support from the Health Region in stopping their use of tobacco products. Q. Are there any exemptions to the policy? A. Yes. Residents of Special Care Homes owned or operated by Prairie North Health Region, and residents of Saskatchewan Hospital are permitted to smoke or use tobacco in designated outdoor locations on Prairie North Health Region property. Ceremonial use of tobacco and prescribed use of medicinal marijuana are permitted in PNHR facilities. Q. If Prairie North Health Region wants me to comply with policy, how is the Region providing assistance to help me reduce or quit smoking or using tobacco? A. Prairie North Health Region has established criteria and processes to help patients and residents in our hospitals and special care homes improve their health by becoming smoke and tobacco-free. Access to advice and counselling is available to all people to assist them in lowering or overcoming their addiction to tobacco. Numerous online resources such as Smokers Helpline are also available to help people become tobacco and smoke-free. Resources are available to our health care providers to assist them in improving their health by quitting smoking or using other tobacco products, and reducing exposure of their patients and colleagues, families and friends to second-hand smoke. We believe that if we can help reduce the prevalence of tobacco use and smoking, we will positively impact the health status, health outcomes, quality of life, and demands on the health system for our clients, health care providers and the population as a whole.

2 Tobacco & Smoke Free Policy Questions & Answers Page 2 of 7 Q. How can I best support the policy? A. We all have a role to play in creating healthier communities. If you are a smoker or user of other tobacco products, you can best support this policy by not smoking as you come on to Prairie North Health Region property, and by moving off of Prairie North property when you are going to use tobacco products. Non-smokers can help support the policy by respecting that adhering to the policy may be difficult for tobacco users and by providing encouragement to smokers who choose to quit, and continuing to respect the right to choose. We are asking our employees and physicians to help ensure patients and residents are aware of the supports available to individuals to help them quit smoking or using tobacco. We are also asking employees and physicians to take an active role in making people aware of the policy by politely asking people to refrain from smoking on Prairie North property or move off PNHR property to use tobacco products. Staff and physicians are neither to provide nor accept tobacco products to/from people under our care, unless for ceremonial purposes. Responsibilities Q. What are people s responsibilities under the policy? A. All individuals accessing Prairie North Health Region properties share responsibility for adhering to the policy, thereby helping to ensure a healthier tobacco and smoke-free environment for all who seek and receive care, deliver services in, and visit Prairie North Health Region sites. All individuals who smoke or use tobacco products are responsible for the safe, appropriate disposal of their tobacco products. Littering of tobacco products is not acceptable on PNHR grounds or perimeters of Prairie North property. Application of the Policy Q. Does the policy apply to all Prairie North Health Region property, including in the Region s rural communities? What about the Region s affiliate Villa Pascal in North Battleford and Dr. Cooke Extended Care Centre on the Alberta side of Lloydminster? A. Yes. Prairie North Health Region s Tobacco and Smoke-Free Policy applies to ALL property owned or operated by the Health Region in all communities we serve. This includes hospitals, special care homes, health centres, primary health care locations, community/public health sites, mental health service locations, office locations, and all others. Q. Does the policy apply to the Villa Pascal special care home in North Battleford, since the facility is not owned or operated by Prairie North Health Region? A. Villa Pascal is PNHR s only affiliate facility, owned and operated by a separate organization. Villa Pascal works very closely with Prairie North in delivering care and service, and following the Region s policies. Villa Pascal is following Prairie North s Tobacco and Smoke-Free Policy as well. Q. Does the policy apply to Dr. Cooke Extended Care Centre, located on the Alberta side of Lloydminster? A. Prairie North Health Region operates Dr. Cooke Extended Care Centre under agreement with Alberta. Employees and residents/clients at DCECC are those of Prairie North regardless of whether they call Alberta or Saskatchewan home. The Tobacco and Smoke-Free Policy applies to everyone who resides or works in Dr. Cooke Extended Care Centre. Q. How does the policy apply to locations where Prairie North Health Region leases and functions in only a portion of a building or site, such as the Don Ross Centre in North Battleford?

3 Tobacco & Smoke Free Policy Questions & Answers Page 3 of 7 A. The Tobacco and Smoke-Free Policy applies to the space leased and operated by the Region, including parking areas set aside for Prairie North. Smoking or other tobacco use is not permitted in these spaces. It is up to the building or property owner to determine if smoking or tobacco use is permitted on the remainder of the property. PNHR encourages our staff members who work in leased locations, such as the Don Ross Centre, to be role models and support our policy by moving off the property if they wish to use tobacco or smoke. Q. Does the policy apply to my doctor s office? A. The policy applies to your doctor s office if your doctor s office is located in a facility or space owned, leased, or operated by Prairie North Health Region, such as the Primary Health Centre in North Battleford, the Associate Clinic in Meadow Lake, and the Prairie North Health Centre physician clinic in Lloydminster, to name a few. The policy does not apply to physician clinics that are privately owned and operated. Q. How will I know whether I am off or on Prairie North Health Region property? Where are the property boundaries? A. Property boundaries vary among Prairie North Health Region facilities. At many of our health care facilities, property lines are fairly clearly defined by the sidewalks and roadways that surround each site. The same is true where our facilities are situated on clearly identifiable blocks within the communities. Prairie North Health Region recognizes that property boundaries are far less obvious in locations such as Saskatchewan Hospital North Battleford and Battlefords District Care Centre in Battleford. Where an individual is uncertain about the site s property boundary, Prairie North encourages people to err on the side of compliance with the policy and not smoke or use tobacco products at all. Q. Can I smoke in my vehicle if it is parked on Prairie North Health Region property? A. No. The Tobacco and Smoke-Free Policy prohibits smoking or tobacco use in all vehicles stopped or parked on property owned or operated by Prairie North Health Region. Smoking in vehicles is strongly opposed due to the risks of exposure to second-hand smoke in confined spaces. Smoking or tobacco use is not permitted in vehicles owned or operated by the Region. Q. I receive health services in my home. Since it is my home, can t I smoke there if I want? A. As an employer, Prairie North Health Region has a responsibility to protect our employees from the harmful effects of exposure to second-hand smoke. We ask that when our employees are to provide a service in your home, you refrain from smoking at least half an hour before the health care worker arrives, and that you do not smoke while the health care worker is there. Q. What if I use spit tobacco? Does the policy apply? A. Prairie North Health Region s Tobacco and Smoke-Free Policy applies to the use of all tobacco products including spit tobacco. The use of spit tobacco (snuff/chewing tobacco) represents a significant health risk and is not a safe substitute for smoking. Here are some facts you should know about using spit tobacco: Spit tobacco is made from a mixture of tobacco, nicotine, abrasives, sweeteners and salts. It contains over 4,000 chemicals including 28 known carcinogens. Nicotine is the main ingredient in spit tobacco and users become addicted just as they would to smoking cigarettes. The amount of nicotine in one dip or chew of spit tobacco can deliver up to five times the amount found in one cigarette. Spit tobacco users are 50 times more likely than non-users to contract cancers of the cheek, gums and inner surface of the lips. Spit tobacco can also cause cancers of the oesophagus, larynx, stomach, pancreas and prostate. Spit tobacco contributes to tooth decay, gum disease and tooth loss, and users are at risk for heart disease, hypertension and heart attacks. (Source: Oral Health America 2001)

4 Tobacco & Smoke Free Policy Questions & Answers Page 4 of 7 Services and Benefits for Patients, Residents and Clients Q. What help is available to patients, residents, and clients in Prairie North Health Region facilities to support these individuals in complying with the Tobacco and Smoke-Free Policy? A. Prairie North Health Region feels individuals success in reducing or stopping smoking and tobacco use will be increased by providing a variety of supports for patients, residents and clients admitted to our facilities. A number of supports and services are available to patients, residents and clients: Nicotine Replacement Therapy (NRT) is available at no cost for patients admitted to any PNHR acute care facility for the duration of their stay in the hospital or acute mental health care unit. Nicotine Replacement Therapy is available at no cost for clients admitted to Hopeview Recovery Centre and Robert Simard Social Detox Unit for the duration of their stay in the facility/unit. Tobacco Cessation Agents are available to residents of Prairie North Health Region Special Care Homes, free of charge, to a lifetime maximum of $300 per person. Tobacco Cessation Agents are available to residents of Saskatchewan Hospital. Brief three- to five-minute tobacco cessation counselling and policy communication are integrated into nursing practice in acute and special care facilities, and is offered to clients. Access to Addictions counselling is available to provide consultative support, education and one-on-one or group counselling for clients. Q. What do you mean by Nicotine Replacement Therapy and Tobacco Cessation Agents. Are they different or one in the same? A. Nicotine Replacement Therapy/products are generally those that are available over-the-counter from pharmacies or other retail outlets. These products include nicotine patches, nicotine gum, nicotine lozenges, and nicotine inhalers. Nicotine replacement products are one type of Tobacco Cessation Agents. Tobacco Cessation Agents also include products available only by prescription, such as bupropion (Zyban ) and varenicline (Champix ). Prairie North Health Region believes individuals success in reducing or stopping tobacco use will be increased by providing the patients, residents and clients admitted to our facilities, with the nicotine replacement therapies that are appropriate for them. Q. How will nurses provide brief smoking/tobacco cessation counselling in hospitals and special care homes? A. All patients being admitted to Prairie North Health Region facilities are informed about the Tobacco and Smoke-Free Policy, and are asked whether they smoke or use tobacco. Nurses will provide smokers/tobacco users with a brief three- to five-minute assessment and counselling session. This includes asking about the individual s smoking/tobacco behaviour and his/or her readiness to quit. Access to the Region s supports will be offered to patients, residents and clients being admitted to our facilities. Referral to an addictions counsellor for continued support in hospital or community is also available. Q. What if my nurse does not offer me brief smoking/tobacco cessation counselling in my hospital or special care home? A. Please make your nurse aware of your interest in quitting tobacco or accessing supports, so that the nurse can assist you. Q. How many times can I access stop-smoking/tobacco cessation supports at the Region s expense? A. This service can be accessed on each occasion you are admitted to a Prairie North acute care/hospital facility. Residents of PNHR special care homes can access the supports without charge, to a lifetime maximum of $300 per person. Nicotine replacement therapy is available to clients admitted to Hopeview Recovery Centre and Robert Simard Social Detox Unit for their duration of their stay in the facility/unit.

5 Tobacco & Smoke Free Policy Questions & Answers Page 5 of 7 Q. Once I am discharged from hospital or other PNHR facility, can I still access free nicotine replacement therapy to better ensure my success upon returning home? Can my family members access free nicotine replacement therapy to help support me as well? A. No. Access to NRT at the health region s expense is available only while you are a patient/resident/client in our hospitals, special care homes, or other facilities. Family members interested in quitting smoking can access nicotine replacement therapy at their own expense at pharmacies and other retail outlets. You and your family members are encouraged to contact your individual insurance providers, if applicable, about NRT coverage that may be available. If you have accessed NRT while a patient, resident, or client in hospital or other PNHR locations, you are encouraged to continue your efforts to quit smoking once you are home. Counselling support continues to be available to you through PNHR Mental Health and Addictions Services. Your family members and the general public have access at all times to tobacco cessation counselling at no charge through Prairie North s Mental Health and Addictions Services. Counselling services help increase an individual s rate of success in overcoming tobacco addiction and help teach individuals and family members how to effectively support one another. Having the proper support systems in place is a crucial part of successfully quitting tobacco use. You can find out more about tobacco cessation though a number of help line and online supports and agencies. Benefits and Services for PNHR Employees and Physicians Q. What supports are available to Prairie North Health Region employees and physicians? A. An important part of having smoke and tobacco-free workplaces and property is supporting employees and others who deliver service, to stop smoking or using tobacco products. Supports are available to PNHR employees and physicians to help them reduce or stop their tobacco use. Prescription tobacco cessation agents such as bupropion (Zyban ) and varenicline (Champix ) are eligible for coverage under the SAHO Group Benefit Plan and are limited to a lifetime maximum of $100 per insured person. Prescription tobacco cessation agents and over-the-counter nicotine replacement products such as nicotine patches, gum, lozenges and inhalers will be reimbursed by Prairie North Health Region for our employees and physicians, up to a maximum of $200 until March 31, Access to Addictions counselling is available to provide consultative support, education and one-on-one or group counselling for Health Region employees and physicians. Q. What coverage do Prairie North Health Region employees access first? A. For prescribed tobacco agents such as Zyban or Champix, employees are to access the SAHO Group Benefit Plan coverage first. For amounts not covered under the SAHO plan, access the reimbursement available from Prairie North Health Region. For non-prescription (over-the-counter) tobacco cessation agents, access the reimbursement available from PNHR. Q. How do employees and physicians get reimbursed from Prairie North Health Region? A. Requirements and processes are in place for reimbursement from Prairie North Health Region: Employees and physicians must complete the standard Prairie North Regional Health Authority Expense Claim Form and attach original receipts for the tobacco cessation agents for which they are seeking reimbursement. If the employee is requesting reimbursement from Prairie North for amounts already submitted to the SAHO plan and not covered, the employee must submit the Claim Information statement provided to the employee by the Benefit Plan. Employees submit the completed PNRHA Expense Claim Form and attached receipts/claim information statement to their supervisor for approval. The existing process for submission of the form and receipts to PNHR Finance Accounts Payable Department is then followed for payment of the claim.

6 Tobacco & Smoke Free Policy Questions & Answers Page 6 of 7 Physicians submit the completed PNRHA Expense Claim Form and attached receipts to the Vice President of Medical Services for approval. The existing process for submission of the form and receipts to PNHR Finance Accounts Payable Department is followed for payment of the claim. Q. How do employees and physicians access tobacco cessation counselling? Tobacco cessation counselling is available to employees and physicians through Mental Health and Addictions Services. You may contact the location nearest you: Lloydminster (306) Maidstone (306) Meadow Lake (306) North Battleford (306) Counselling is available through the Employee and Family Assistance Plan (EFAP) at Support is also available over the phone and online from the Smokers Helpline at (Saskatchewan) or (Alberta). Exemptions Q. Why are Special Care Home residents and residents of Saskatchewan Hospital allowed to continue smoking? A. Prairie North Health Region is greatly concerned about the health of residents in our facilities who use tobacco products, but we also recognize that Saskatchewan Hospital and Special Care Homes are residents homes. Under the Tobacco Control Act, Special Care Homes are permitted to allow smoking in designated locations. Prairie North Health Region therefore continues to allow Special Care Home and Saskatchewan Hospital residents to smoke on PNHR property, but only in designated outdoor locations. We also continue to educate residents about the dangers of tobacco use and about smoking cessation support and services available. Q. Can family members, visitors, or employees at Special Care Homes and Saskatchewan Hospital continue to smoke in the designated outdoor smoking locations? A. No. The Special Care Home/Saskatchewan Hospital exemption applies to residents only. This means all employees, visitors, and family members are required to move off Health Region property to smoke or use tobacco products. Q. What about palliative care or long-term care patients in hospitals, mental health patients in acute care locations including Battlefords Mental Health Centre, clients of Hopeview Recovery Centre in North Battleford, and clients of Robert Simard Social Detox Unit in Meadow Lake? Why don t these people have an exemption as well? A. Although we recognize that the change to a tobacco and smoke-free environment will be difficult for these individuals, none of the health care facilities in which they are receiving service are intended to be permanent residences. Supporting exemptions for these clients would be inappropriate for Prairie North Health Region because we would be assisting them, as individuals under our care, to engage in what we know to be unhealthy behaviour. Prairie North Health Region will provide supports to these clients to assist them in adapting to a tobacco and smoke-free environment. Q. What if I want to continue using tobacco products when receiving care or visiting at a Prairie North Health Region facility? We urge tobacco users to refrain from using tobacco products while receiving care or visiting at any of our facilities. Patients are encouraged to remain on property while under our care. If you are a patient and choose to use tobacco products while receiving care, you will be required to sign a waiver to go off our property. We encourage everyone to be accountable for their personal safety, including exercising caution and being aware of the surroundings when leaving the grounds.

7 Tobacco & Smoke Free Policy Questions & Answers Page 7 of 7 Enforcement of the Policy Q. How is the policy enforced? A. The policy is enforced by Prairie North Health Region through an informative and educational process. Signage is posted near property perimeters and near facility entrances, reminding people that all PNHR property is tobacco and smoke-free. We believe people will understand and respect the health environment they are in. People found smoking on the property may be approached, politely informed or reminded about the policy, and asked for their cooperation. The advisory or information about the policy may be spoken or provided in writing in the form of a tobacco and smoke-free policy reminder. We are confident people will respect the policy once they have been made aware. Q. What will happen if patients or visitors refuse to comply with the policy? A. If a smoker/tobacco user chooses to be non-compliant with the policy, the individual can expect to be repeatedly approached to ensure he or she is educated and aware of the policy. Response protocols are in place to help guide individuals choosing to inform non-compliant persons of the policy. Where an individual is found to be in continuing violation of the policy and, under the Saskatchewan Tobacco Control Act, is within three meters of doorways, windows, and air intakes of Prairie North Health Region facilities, Public Health Inspection may be consulted regarding further action under the provincial legislation. Q. What will happen if Prairie North employees, physicians or others providing service on PNHR property refuse to comply with the policy? A. If an employee, physician, or other service provider chooses to be non-compliant with the policy, he or she can expect to be repeatedly approached to ensure the individual is educated and aware of the policy. Response protocols are in place to help guide individuals choosing to inform non-compliant persons of the policy. Continued non-compliance may be subject to further action as permitted under Prairie North Health Region policies, contracts, and/or legislation.