Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Community Medicine

Background: The best way to protect smoker and non-smokers' health is to provide a smoke-free environment. Hospitals should be 100% smoke-free for the health of all patients, workers and visitors. Aim: Achieving smoking free hospital.Methodology: Health service intervention study conducted at Internal Medicine Hospital (IMH). Smoking behavior, the knowledge, attitude and practice (KAP) of 458 health care workers (HCWs) and 204 patients towards smoke-free policy implementation at the hospital were assessed in pre (237 HCWs and 102 patients) and post intervention (221 HCWs and 102 patients). The intervention included drafting Kasr Alainy smoking free policy, training session and face to face orientation to HCWs to improve their KAP towards the developed policy and its implementation; formulation of tobacco control team, and environmental modification (posting of the policy, NO smoking signs, health education materials, smoking designated areas).Results: The prevalence of current smoking inmale HCWs was 19.8% and 18.6% while it was 42.8 % and 22.6 % in patients in pre and post intervention groups. Majority of HCWS were exposed to second hand smoking (SHS). Knowledge of HCWs and patients improved significantly in some areas, positive attitude was high from the start and practices of policy implementation improved significantly in HCWs and patients.Conclusion: Overall, smoke-free policy practices improved after intervention. Some areas of knowledge still need to be addressed for achieving 100% smoke free hospital. There is a need for additional measures such as enforcing the protocol of fining smokers in the hospital and smoking cessation service support at the hospital

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