Just what the docs ordered

SEATTLE – Chuck Koslosky hardly knows an adult life without Northwest Hospital & Medical Center.

“This is my hospital,” said Koslosky, pointing to the floor with his forefingers as if to root his statement in the ground.

On his way outside for a morning cigarette, Koslosky navigates the mazelike back hallways of Northwest with ease. The 50-year-old maintenance manager started working at Northwest in 1980 as a janitor.

He’s been a smoker even longer. He bummed his first cigarette while hanging out at the Seattle Center. He was 12.

But those two Koslosky constants – Northwest and smoking – are not long for coexistence.

The hospital, with its sprawling 33-acre campus in north Seattle, will go entirely smoke-free – inside and out – in 2006.

“We are a hospital, and one of our missions is to improve the health status of not only our patients, but our employees and the surrounding community,” said Dr. Mark Kimmins, a surgeon and member of Northwest’s Cancer Committee, the group that first proposed the switch to smoke-free.

The goal, he said, is to help smokers quit and protect visitors from secondhand smoke.

The change at Northwest has long been in the works, but it coincides with Initiative 901, which, if it passes in November, could force other hospitals to consider pushing smokers farther out. The initiative would ban smoking within 25 feet of doors, windows and ventilation at workplaces and buildings used by the public, including hospitals.

Although hospitals and not smoking would seem to go hand in hand, a survey turned up just one other hospital in Seattle – Virginia Mason Medical Center – that is smoke-free.

Nationwide, experts say a growing number of U.S. hospitals are opting for a smoke-free approach. A 1996 study from the University of Missouri at Columbia School of Medicine found that 41 percent of hospitals had a total smoking ban.

While all Seattle hospitals forbid smoking inside their buildings, most have designated smoking areas on patios or other spots outside for staff, patients and visitors.

Children’s Hospital and Regional Medical Center, for example, has two smoking areas, one exclusively for staff and the other for parents and visitors.

Virginia Mason Medical Center hasn’t allowed smoking anywhere on its property since 1991.

Determined smokers don’t have to go far, however. They can light up on city sidewalks just outside the First Hill facility.

“It seems at first very straightforward, but there are lots of challenges (to) maintaining a smoke-free environment,” said Todd Johnson, vice president at Virginia Mason. “It can be a very emotionally tough time for patients and visitors. That doesn’t change the fact that we don’t want them to smoke on our property, but it certainly dictates (using) sensitivity.”

In Grand Rapids, Mich., all three acute-care hospitals banned smoking three years ago.

Enforcing the ban has been trickier than anticipated, said Micki Benz, spokeswoman for St. Mary’s Health Care in Grand Rapids.

The security staff realized early on they’d need to enlist everybody who worked at the hospital in order to extinguish all butts, Benz said.

The entire staff received instruction and a script to use when approaching smokers: “Excuse me ma’am/sir, but there’s no smoking on campus.”

Still, smokers find hidden nooks – behind buildings, or in their cars in the parking lot, Benz said.

“I’m certainly no proponent of smoking, but I also sometimes think twice when I see a family smoking outside the emergency room,” Benz said. “I think to myself, ‘Is this the time for me to say you shouldn’t be smoking out here?’ “

Absolutely, says Roger Valdez, manager of the Tobacco Prevention Program at Public Health – Seattle & King County.

“So many people view hospitals and doctors as being the authority on what’s healthy and what’s not,” Valdez said. “When a hospital says ‘You can’t smoke on our campus,’ that really is a strong message.”

In 1993, the Joint Commission on the Accreditation of Healthcare Organizations implemented new standards requiring hospitals to prohibit smoking inside their facilities.

The commission has remained mum, however, on the subject of campuswide smoking bans.

For Koslosky, Northwest’s new policy is incentive enough to give up a habit of more than three decades. Except for a three-year stretch as a teenager, he hasn’t quit for any significant length of time.

He plans to go cold turkey, an approach that worked for his 60-year-old father after a lifetime of smoking.

“There’s a security that I’m going to miss,” said Koslosky. “Maybe I’ll just get a blanket.”