Seven Steps To Tobacco-Free

Moving to a tobacco-free environment takes planning, time, and incremental implementation. Not every hospital, health system or other caregiver will start their tobacco-free efforts the same way, or in the same place. With input from the Massachusetts Department of Public Health (DPH), MHA developed seven steps healthcare facilities can take to become tobacco-free. These steps are important building blocks for the successful implementation of an organization's tobacco-free policy, and as such MHA recognizes hospitals, health systems and other affiliated caregivers for accomplishing each of the seven steps and for becoming tobacco-free. 

1.) Established Committee or Workgroup

Include representation from multiple areas including senior management, administration, facilities, client services, HR, medical staff, communications/community relations, and tobacco users
Schedule regular meetings to develop an implementation plan with a specific date to be completely tobacco-free. Committee should provide monthly/quarterly reports to senior management along with an internal email/newsletter update
Complete within the first month of the initiative
2.) Board approved tobacco-free policy with a specific implementation date

Assess current tobacco/smoking policies and create a tobacco-free policy with clearly defined goals and dates for implementation that will enable a smooth transition
Review draft policy with legal counsel, union rep, and other key stakeholders
Present action plan to board for input and approval
Make necessary changes to policy
Complete within 2-5 months
Resources for Tobacco-Free Policy Implementation 
3.) Internal and external communication and countdown

Develop internal/external communications plan, signage, and collateral
o Use the MHA Tobacco-Free Communications Tool Kit 
Inform staff of policy and implementation date and timeline
o Draft Frequently Asked Questions
o Explain reasons for going tobacco-free and the effects on staff
o Address possible concerns of staff
Reach out to the community with preliminary policy plans and keep media informed as benchmarks are met
Complete within 6-8 months
4.) Smoking cessation and support programs for patients, staff, and the community

Inform staff, patients and community members that the hospital is tobacco-free and tobacco use of any kind will not be permitted anywhere on the campus.
o Upon admittance, ask patients and/or visitors if they use tobacco products and offer cessation resources and tobacco-abatement products.
Develop a tobacco cessation program that includes: 
o Information on self-help cessation resources
o Pharmaceutical cessation aids to patients and staff 
o Individual and group counseling services
o Reimbursement included in employee benefits
o Community-based cessation programs
* QuitWorks - Free telephone counseling (1-800-QUITNOW)
Begin as soon as initiative is publicized and complete within 8-10 months of starting
Visit MHA's Tobacco Cessation Resources page
o Massachusetts Tobacco Cessation & Prevention Program
o BPHC Tobacco Control Division
o Tobacco in Massachusetts Fact Sheet
o Tobacco-Free Hospitals Briefing Paper 
o How to Build a Tobacco-Free Workplace: Employers’ Toolkit
Systems for identifying, treating and an referring patients for help
o QuitWorks -  a provider fax or electronic referral program to the state’s quitline
o MassHealth Tobacco Cessation Benefits

5.) Staff trained and support systems created

Train staff to address the needs of patients and visitors dependent on tobacco products
o Policy enforcement tactics and procedures
o Referrals to counseling or cessation programs
Implement programs to aid patients and visitors with cessation
Establish enforcement policies
Complete within 10-11 months
6.) Signage and other collateral

Walk through the campus and decide where signs will be placed
Print brochures, table tents, and posters detailing the tobacco-free policy and key changes
o MHA Tobacco-Free Logo 
Print materials detailing cessation resources available to patients and staff
Complete within 11-12 months
7.) Implementation, publicity, enforcement, and feedback

Remove ash receptacles and update signage on campus
Publically celebrate implementation day with community members and local media
o Share and celebrate positive stories of employee success with cessation
Post enactment:
o Talk with staff and patients to gain feedback about the policy
o Schedule ongoing meetings to assess the effectiveness of the policy
o Make necessary changes to policy
Share Success Stories 
o Please let us know if you would like to share your hospital's story!