Benchmarking Survey

Overview

A 19-item questionnaire was sent to more than 100 external organizations in February 2007 to learn more about their respective tobacco policies. Institutions contacted included members of the University System of Georgia, the Department of Technical and Adult Education, the Association of Academic Health Centers, the University Health System Consortium, and other groups related to health care and higher education.

 

Respondent Profile

A total of 47 organizations answered the questionnaire.  Most respondents (81 percent) were from colleges and universities.  Forty percent of all respondents represented publicly funded/assisted entities, and forty percent labeled themselves as academic health centers or medical schools.  Although half of the respondents (51 percent) were from Georgia organizations, other states represented included Florida, Hawaii, Illinois, Kansas, Kentucky, Louisiana, Missouri, New York, North Carolina, Ohio, Oklahoma, Tennessee, Texas, Virginia, West Virginia, and Wisconsin. Organizations’ sizes ranged from 500 to 50,000 individuals (employees, students, etc.) with a mean of 13,220.  The largest percentages of organizations (24 percent) reported between 2,000 and 4,999 individuals, or between 10,000 and 29,999 individuals. 

 

Organizations with Full Tobacco-Free Status

Description:  Twenty-nine (62 percent) organizations reported “smoke/tobacco free on select property,” followed by nine (19 percent) “tobacco free on all property,” and five (11 percent) “smoke free on all property.”  Only four (8.5 percent) organizations were not smoke/tobacco free to some degree.  Of the 12 organizations that had smoke/tobacco free policies, the range of time they had been smoke/tobacco free was a mean of 9.4 years.  The largest percentage of organizations who responded to this question (42 percent) reported being smoke/tobacco free for five to 10 years. 

Motivation:  The largest percentage of organizations reported their primary motivation for becoming totally smoke/tobacco free is the desire to improve the health of members and to set a standard of wellness among other organizations (38.5 percent and 30.8 percent, respectively). 

Implementation:  Most organizations (46%) went “cold turkey,” meaning the policy was in effect as soon as it was announced; this method was followed by 38.5 percent that implemented the policy “gradually” within several months. Another 38.5 percent implemented “unilaterally,” without contributions from across the organization, while only two (15 percent) organizations implemented multilaterally, with contributions from across the organization.   

 

Those surveyed responded with the following as average percentages of estimated smokers for their organization: 12.9 percent employees, 15 percent students, and 26 percent patients.  These percentages were derived primarily from estimates of state/national statistics (44 percent) as opposed to surveys within organizations.

Organizational Support:  Support provided for employees/faculty tobacco users was primarily smoking cessation treatment (individual/group) paid for by the organization (70 percent).  The next largest percentage (40 percent) provided smoking cessation treatment paid for by the organization’s insurance provider.  Thirty percent of the organizations reported nicotine replacement therapy paid for by the organization.

In terms of student support, 87.5 percent of organizations reported smoking cessation individual/group treatment paid for by the organization and 25 percent reported individual/group treatment covered by student health insurance.

The majority of organizations (67 percent) expected patient tobacco users to pay for smoking/tobacco treatment themselves.  One organization each reported the following means of support:  1) smoking cessation treatment paid for by the organization; 2) a nurse or other healthcare provider employed by the organization to counsel and refer patients for treatment; 2) nicotine replacement therapy paid for by the organization; and 4) distribution of brochures about treatment.

Community response:  In general, organizations reported a positive response or publicity from local media, local politicians, other local organizations, state politicians, media in other parts of the state, national media, national politicians and national organizations.  Only one organization reported negative response from a tobacco users’ rights group.

All organizations who responded communicated its smoke/tobacco free policy both internally and externally through the following channels:  internal newspaper or newsletter, town hall meetings or other organizational assemblies, email, word-of-mouth, managers, fliers or posters, memos or other mail correspondence, and all external media (television, newspaper, etc.).  The overall response internally was either supportive (82 percent) or enthusiastic (18 percent).  The overall response externally was supportive (50 percent), enthusiastic (12 percent), or apathetic (38 percent). 

Consequences:  Tobacco users found to “got around” the smoke/tobacco-free policy by using in their cars (90 percent), going to nearby properties to smoke (80 percent), or general non-compliance (40 percent).  All organizations reported progressive sanctions for violating the smoke/tobacco-free policy.  Consequences reported were verbal warning (100 percent), written warning (70 percent), termination (50 percent), monetary fine (10 percent), and citation on performance evaluation (10 percent). 

Impact:  All organizations (100 percent) reported no impact on the organization as a result of going smoke/tobacco free in each of the following categories:  revenue, non-faculty employees, non-faculty and faculty employment recruitment, inpatient and outpatient volume, volunteers, student enrollment or student applications.  Likewise, responses to questions about satisfaction indicated higher satisfaction among all stakeholders except for one organization (11 percent) that reported lower satisfaction among students.  The vast majority of organizations reported no legal challenges since implementing their smoke/tobacco-free policy (89 percent), with one organization reporting a state legislator’s challenge and one reporting a local ordinance challenge.

Behavioral health:  Psychiatric inpatients were not permitted to use tobacco by the majority (75 percent) of the organizations reporting.  One organization each (25 percent) reported the following: permitted smoking in an outside area accessible only from the inpatient psychiatric unit; permitted tobacco use in a separate staff-supervised smoking area; permitted tobacco use outside a certain area from facility entrances; not permitted to use tobacco and are ordered nicotine replacement therapy without the patient’s consent. 

 

Organizations with Limited Tobacco/Smoke-Free Policy

In regards to reasons organizations had not expanded smoke/tobacco free policies to include all organization-owned properties, the majority of organizations (52 percent) responded in the “other category.”  These reasons included no interest; satisfaction with what the law dictates; respect for individual rights; smoking addressed, but not tobacco use; negative legislative or public response in tobacco-growing states; difficult to enforce; or culture. Eighteen percent reported they had tried to implement a smoke/tobacco-free policy but received a negative response.  Another 18.5 percent plan to implement a smoke/tobacco-free policy in the future and 11 percent did not perceive tobacco use to have a negative impact on the organization’s operations.  Of those organizations that planned to implement a more comprehensive policy in the future, 74 percent had not set a specific timeline and 16 percent planned to implement within one to two years.

 

Organizations with No Tobacco/Smoke-Free Policy

In regards to reasons organizations had not adopted a smoke/tobacco free policy, 75 percent responded in the “other category.”  The stated reasons included making campus welcoming to all students, currently in process of implementing, abiding by state law, limiting smoking to outside 25 feet of entrances, and smokeless tobacco permitted.  Fifty percent reported planning to implement a smoke/tobacco free policy in the future, with 67 percent of those planning to implement in less than a year and 33 percent having no specific timeline.