Walking Our Talk

Tobacco Free Initiative

As 2006 drew to a close, the American Cancer Society was putting the finishing touches on a report that summarized the most noteworthy conclusions gleaned from major recent research initiatives.

The most significant finding was probably the least surprising; namely, that an estimated one-third of cancer cases could be attributed directly to tobacco use.

Even before this information was shared publicly, however, CHS leaders had reached consensus that bold new action was necessary to stem tobacco use, both among employees and within the community at large.

The System’s previous policy on tobacco, which banned smoking inside CHS offices and facilities, dated back to 1991. Over time, however, the limitations of a partial ban became more and more pronounced. In many cases, for example, the problem of on-site smoking didn’t go away; it simply moved outdoors and became even more visible to visitors and passers-by.

CHS ultimately determined that more drastic action was needed, both to protect employee health and to reinforce the seriousness of anti-tobacco messages being sent out by every part of the medical establishment. Accordingly, the governing board announced a much tougher policy at the beginning of 2006, to be phased in over a one-year period.

The new policy, which banned smoking by employees, patients or visitors—anywhere indoors or outdoors on CHS-owned property—was formally implemented in conjunction with the Great American Smokeout on November 16, 2006. Affected facilities included the four CMC hospitals in Charlotte, along with all CPN practices and the Charlotte area long-term care facilities. Other CHS facilities, such as CMC-Union, had already adopted total smoking bans, and still others were making plans to follow.

In making this change, CHS became the largest hospital system in North Carolina to adopt such a stance, and the first system to do so in Charlotte.

The most immediate impact, of course, was on occupants and visitors. These included some 17,500 Charlotte area employees, in addition to all those individuals coming and going in conjunction with more than one million patient visits annually.

Beyond this benefit, the new policy had symbolic influence that Dr. Melva Okun of North Carolinas Prevention Partners, a smoke-free advocacy group, calls “immediate and profound.”

“It would be difficult,” Dr. Okun says, “to adequately credit the importance that this change had for public health, not only within CMC’s immediate service area but on a statewide basis. CHS set itself apart by being so proactive in furnishing support to smokers, including employees and visitors alike. Also, CHS took on an impressive and meaningful statewide leadership role with respect to public education.”

Dr. Okun, who travels throughout the United States as a speaker and program facilitator, notes that CHS is cited frequently as a national success story. “There’s a lingering perception throughout the country,” she says, “that really large organizations cannot implement such a radical change successfully. The experience at CHS proves that this assumption is just plain wrong.”

Okun believes the CHS changeover in 2006 also had a profound “bandwagon effect,” providing momentum to smoking eradication efforts in a wide variety of businesses and organizations outside the healthcare industry.

“There is growing pressure throughout the state now to pursue smoking bans in restaurants and other public places. The movement has even taken root in traditional tobacco strongholds like Winston-Salem. The General Assembly itself went smoke-free during 2006. I don’t believe these kinds of changes would have occurred nearly so rapidly without the CHS example.”

According to Dr. Jessica Schorr Saxe, medical director of prevention and community wellness for CHS, the new policy has been “extremely well received.” She said most employees welcomed the change and some even questioned why it took so long.  

Among smokers, she said, cooperation has been “quite good,” with a significant number taking advantage of nicotine replacement therapy and other forms of assistance which were incorporated into the employee benefit program.

“We are not aware of any employee turnover specifically related to the new policy,” she says, “and disciplinary problems have been minimal. All in all it’s been a terrific change. We are a far healthier community because of it.”

Such sentiments are echoed by Luther Brooks, 74, a plant operations coordinator who quit smoking cold turkey in June of 2006. Brooks was a 2 ½ pack-per-day smoker who had been using tobacco for some 60 years. Brooks says the decision not only made his wife “the happiest person in the world,” but had an impact on several of his fellow employees.

“They all said the same thing,” Brooks recalls. “If a 60-year smoker can lay them down, so can we!”

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