NO SMOKING POLICY ADM 130
TheTurks&CaicosIslandHospitalsaimtoprovideasafe, cleanandsmokefreeenvironmentforallpartieswhoenter orusethefacilitiesatbothGrandTurkandCheshireHall MedicalCentre
Forthosewhoarenon-smokers,secondhandsmokeis offensiveForpatients,thissmokemayaggravatemedical conditions.Theuseofcigarettesintheworkplaceincreases fireriskbyunextinguishedcigarettes,ofparticularconcernin TCIasaresultofthedryterrainweexperience.
Cleardirectionisprovidedforallemployeesfromthepointof recruitment,withtherequirementfor‘NoSmoking’tobe referencedinallJobDescriptions,inHealthandSafety literatureduringinductions,throughsignageatourentrances andthroughoutthebuilding,andthroughcommunications viatheHealth&SafetyCommittee
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Welcome Team Member to another session of ‘Policy Corner’ aimed at improving our awareness of Company Policies and what they mean for us as employees. For this edition, we will be looking at TCIH No Smoking Policy and the requirements for Staff,PatientsandVisitorsatTCIHospitals.
Nowletusconsidersomefrequently askedquestions:
Does this policy apply to the building only?
This covers all parts of the facility, the main and out buildings, compounds, gardens, healinggardensandcarparks.
WhatifIamatworkandoffduty?
InthisarticlewewilltakealookattheHealth and Safety implications of Smoking, but first lets looks at the policy and what is covers fromthePolicyStatement:
4.1. The management of TCI Hospital has a responsibility to ensure that staff are not exposedtohealthrisksfrompassivesmoking atwork.
4.2. Managersandstaff willtakereasonable measures to ensure that this policy is fully implemented at all levels (inpatient units, outpatientunits,externalpremises)toensure compliancewiththispolicy
4.3. All staff must be made aware of this policyandassuchwillbeexpectedtoensure compliance from all volunteers, contractors, patientsandvisitors.
4.4. The Managers will provide staff and patients with the appropriate support (i.e. counsellingoradviceonsmokingcessation)
4.5. Smoking is not allowed in any vehicle owned,leasedorrentedbyTCIHospital.
4.6. Smoking is not allowed in private vehicleswhileonTCIHospitalpremises.
4.7. Smoke breaks are not permitted whilst onduty.
This policy, developed for the safety and healthofall,appliestoallstaff,uniformedor not, and patients, visitors, contractors and workpartners.
What happens if I choose to smoke at work?
Firstly, we would ask you to consider the safety and wellbeing of others. For many, exposure to smoke is offensive at best and harmful at worst. Smoking is known to increase health implications and also risk of fire.Interhealth Canada has developed a policy stating that smoking is not permitted. Staff members who choose to smoke and ignore the policy will be treated as in contraventionofthissafetypolicyandmaybe subjecttoformaldisciplinaryaction.
What happens if I am on duty and a patient asks for my assistance to take them to the healing garden or outside to smoke?
The policy clearly states that the ‘No Smoking’ requirement is for all persons visiting or using the facility, including our patients. In the policy under section 5.5, if further states that staff are not permitted to assistpatientswhowishtosmoke.
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CanIuseanE-cigarette?
No,E-cigarettesarenotpermitted.Thepolicy refers to these alternatives as not being permitted due to being an unregulated nicotine product with limited evidence of health and also safety implications. Below you will see further information relating to known effects of vaping, and also incidents thathavecausedharm.
Now we have covered the policy, let us look at some Health, and Safety Factors relatingtoSmoking:
In line with our ‘People First Philosophy; let us review with that Centres for Disease Control and Prevention says about risks to ourhealthfromsmoking:
Smoking causes 90% of all lung cancer deaths
I am a smoker and want to give up. Is therehelpavailabletome?
Yes, there is. If you are looking for support, your first stop if your Line Manager who will advise you as to the resources and support available for you. This includes Literature, referraltoanOccupationalHealthPhysician, tools within INOVA, the TCIH Employee Assistance Program, and access to support groups.Pleasereachout,ifthisissomething thatyouareconsidering.
WhathappensifIseesomeonebreaching theNoSmokingPolicy?
SmokingintheHospitalisnotpermitted.Itis aswehavecovereddangerous,asaresultof increased fire risk, and also dangerous for persons who may have conditions made more severe from exposure to second hand smoke. For many persons it is deemed unhygienic and offensive, particularly when being cared for by a Healthcare representative.Considerationforthesepoints must be maintained. Those staff members whobreachthispolicymayneedcounselling and support, for those who do not wish to pursuethis,theymaybesubjecttotheformal actionoutlinedabove.Aspersonswitnessing the use of cigarettes and e-cigarettes in the workplace, please report this to your Line Manager,SafetyReporaddanincidentform onDatix.
Ifyouseeapatientofvisitorsmokingorusing a vape, kindly notify the Security team who will politely manage this situation and notify thepersonofthenosmokingrequirementfor TCIHospitals.
More women die from lung cancer each yearthanfrombreastcancer
Smoking causes approx. 80% of all deaths from chronic obstructive pulmonarydisease(COPD)
Smoking doubles the risk of stroke and coronaryheartdisease
Smoking causes diminished overall health,increasedabsenteeismfromwork, and increased health care utilization and cost.
Strongmessagesandnoticesarearoundus, and there is unlimited websites and material supporting the need to cease smoking. Graphics on cigarette packets and such material as seen in the health vs smoker’s lunggraphicbelowareabundant.
If you are looking to stop smoking, please reachoutandmakecontactyourManagerfor support. Some other useful links are seen below:
Checkoutthelinksbelow:
https://www.nhs.uk/live-well/quit-smoking/nhsstop-smoking-services-help-you-quit/+
https://www.cdc.gov/tobacco/campaign/tips/qui t-smoking/index.html
https://ash.org.uk/
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Dangers of Second-hand & Third Hand Smoke
Exposuretosecondhandsmoke(SHS)fromburningtobaccoproductscausesdiseaseand prematuredeathamongpeoplewhodonotsmoke.Thereisnosafelevelofexposureto secondhandsmoke;evenbriefexposurecancauseimmediateharm.
Completelyeliminatingsmokingistheonlywaytofullyprotect personswhodonotsmokefromSHS.Let’sworktogethertoachieve thisinourworkplace.
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E-cigarettes – A Modern, Lower Risk AlternativetoCigarettes?
E -cigarettes have become the modern and for some trendy alternative to conventional smoking.Whilsttherearedeemedahealthier and less anti-social alternative to smoking, great efforts are being made to reduce the appealtoadolescentsandnon-smokerswho are seeking these products as a low or noriskchoice.
Therearehealth andsafety risksassociated withtheseproducts.Theyarecoveredwithin the ‘No Smoking Policy’ for this reason.Risk of fire is covered below, but let us look at whatanE-Cigaretteis:
ElectronicCigarettes–arealsoknownasEcigarettes, vapes, e-hookahs, vape pens, tank systems, mods, and electronic nicotine deliverysystems.
They work by heating a liquid to produce an aerosolthatusersinhaleintotheirlungs. This liquid can contain: nicotine, tetrahydrocannabinol (THC)andcannabinoid (CBD) oils, and other substances, flavourings, and additives. THC is the psychoactive mind-altering compound of marijuanathatproducesthe“high.”
Vitamin E Acetate is used as an additive in THCe-cigaretteproducts.Itisfoundinmany foods, as a dietary supplement and in many skincareproducts. VitaminEacetateusually does not cause harm when ingested as a vitamin supplement or applied to the skin. However, previous research suggests that when vitamin E acetate is inhaled, it may interferewithnormallungfunctioning.
Whatisthedifferencebetweenvapingand smokingcigarettes?
Vaping and smoking both involve inhaling nicotine and other substances into your lungs. E-cigarettes heat liquid to make an aerosol; cigarettes burn tobacco, which createssmoke.
Isvapingworsethancigarettes?
Vaping is often thought of as safer than cigarette smoking, but vaping causes health problems, too.Both vapingandsmokingare addictive and bring potentially dangerous chemicalsintoyourbody.Thelevelsofmany of these chemicals is higher when you burn tobacco. Vaping hasn’t been around long enough to know what kind of long-term damageitmightcause.
Whatdoesvapingdotoyourlungs?
The particles you inhale while vaping can causeinflammation(swelling)andirritationin yourlungs.Thiscanleadtolungdamagelike scarringandnarrowingofthetubesthatbring air in and out of your lungs. Researchers don’tyetknowalltheeffectsvapingcanhave onyourbody.
Isn’tvapingjustwatervapor?
No. Despite the name, vaping doesn’t make watervapor.Itactuallycreatesanaerosol(or mist)thatcontainssmallparticlesofnicotine, metalandotherharmfulsubstances.
What’sine-liquid(e-juice)?
E-liquid, also called e-juice or vape juice, is what vaping devices use to make the vapor you breathe in. E-liquids aren’t just water. Theyusuallycontain:
Flavouring. Each flavouring has its own setofingredients.
Nicotine, the addictive and harmful substanceincigarettesandothertobacco products.
Propylene glycol and glycerine, used to createvapor.
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E-liquids and flavourings sometimes have otheringredients,including:
Chemicals that can cause cancer (carcinogens), like acetaldehyde and formaldehyde.
Chemicalsknowntocauselungdisease, such as acrolein, diacetyl and diethylene glycol.
THC(tetrahydrocannabinol),thechemical inmarijuanathatgetsyou“high.”
Vitamin E acetate, linked to lung injury causedbyvaping(EVALI,seebelow).
Heavy metals like nickel, tin, lead and cadmium.
Tiny(ultrafine)particlesthatcangetdeep intoyourlungs.
Problemsvapingcausesinclude:
Asthma. Vaping can make you more likely to get asthma and other lung conditions. It can make your existing asthmaworse.
Lung scarring. Diacetyl, a chemical used in some flavourings, can cause bronchiolitis obliterans (“popcorn lung”). Bronchiolitisobliteranscausespermanent scarringinyourlungs.
Organdamage.Inadditiontoyourlungs, nicotine and other substances in e-liquid can hurt your heart and brain. We know nicotinecanhurtbraindevelopment,raise your blood pressure and narrow your arteries.
EVALI (e-cigarette, or vaping, product use associated lung injury). EVALI is a seriouslungconditionthatvapingcauses. It causes widespread damage to your lungs and gives you symptoms like coughing, shortness of breath and chest pain.EVALIcanbefatal.
Addiction. Nicotine is highly addictive. It causes changes in your brain so you wantmoreandmorenicotine.Youmight notbeabletostopvapingifyouwantto or if it starts causing health problems. Even e-liquids that say they’re nicotine freehavesmallamountsofnicotine.
Cigarettesmoking.Manypeoplestartout vaping and end up smoking cigarettes, which contain higher amounts of harmful chemicals.
Second-hand exposure. Vaping doesn’t makesmoke,butpeoplearoundyouare exposed to nicotine and other chemicals whenyouvape.
Explosions.Therehavebeenincidentsof batteriesinvapingdevicesexplodingand causingseriousinjuriesandburns.
Cancer Someingredientsine-liquidsare knowntocausecancer.
Forfurtherdetailshttps://cdc.gov/tobacco
E-cigarettes come with safety concerns, this includebatteryexplosions&overheatingrisks Below are two incidents where overheating and explosion occurred for separate Vape users. The first as a result of overcharging and battery explosion. The second with a userwhosevapecaughtfireinhispocket
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For your safety, if you are a user of these products, please see below safety tips for your use and management outside of the workfacility:
Make sure you read and understand the manufacturer's recommendations for use andcareofyourdevice.Ifyourvapedid not come with instructions or you have further questions, contact the manufacturer.
Lookforanysafetymarkingsorwarnings displayedonthebatteryorpackaging
Protect your vape from extreme temperatures by not leaving it in direct sunlightorinyourcaronafreezingcold night.Preventitfromgettingwet,orfrom impactdamage.
Consider using vape devices with safety features,suchasprotectionagainstovercharging, firing button locks and vent holes.
Don't remove or disable safety features that are designed to prevent battery overheatingandexplosions.
The risks around vaping tend to come from counterfeit or faulty products, and poorchargingpractices,sotakealookat ouradvicebelow.
Never let your battery come into contact withmetalitemssuchascoinsorkeysin apocketorbag,asthiscancauseashort circuitandexplosion.
Storeremovableandsparebatteriesina plasticcasetopreventaccidentalcontact. Storethemoutofreachofchildren.
Don’t mix a battery from one supplier or productwithachargerfromanother.
Regularly inspect your vape batteries. If your battery is damaged in any way, leaking or not functioning properly, stop usingitandreplaceit.
Disposeofbatteriessafely.Seekadviceif you are not clear of disposal requirements.
This article goes know where near providing fulleducationandinformationwithregardsto theimpactofsmoking,thesocialimplications, impactonfamilyhealthaswellasyourown. It is intended as food for thought and to provide you with an understanding of the TCIHPolicyrelatingtoNoSmoking,andthe reasonsforthis.
Inadditiontotheusefullinkscontainedwithin the article, please see below a list of resourcesusedaspartofNoSmokingpolicy formulation.
Please feel free to use this list for further readingorreachouttoyourLineManageror Human Resources Representative for support:
Smoking Kills - A White Paper on Tobacco
https://www.gov.uk/government/publications/ a-white-paper-ontobacco
HealthyLives,HealthyPeople
https://www.gov.uk/government/publications/ healthy-lives-healthy-people-ourstrategy-forpublic-health-in-england
WHOFrameworkonTobaccoControlReport on Electronic Nicotine Delivery Systems –July2014.
https://apps.who.int/gb/fctc/PDF/cop6/FCTC_ COP6_10-en.pdf
RCPstatementone-cigarettes–June2014. https://www.rcplondon.ac.uk/search? keys=press%20releases%20rcp%20stateme nt%20ecigarettes
JointCommissionOrganization.(2011,April). KeepingYourHospitalPropertySmoke-Free: Successful Strategies for Effective Policy Enforcement and Maintenance. Retrieved February 27, 2018, from Joint Commission Organization
https://www.jointcommission.org/assets/1/18/ smoke_free_brochure2.pdf
WishingyouallasafeandsmokefreeMarch,andlookingforwardto nextmonth,wherewewillbelookingatlighter,butequallyvital policyofthenewlydeveloped ‘TCIHHospitalCarparkSafetyPolicy’.
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