Fitzpatrick 2012.
| Methods | Country: Ireland, Dublin Setting: Hospital Design: Uncontrolled before‐and‐after study Analysis: Chi² test was used for comparison of proportions and Student's t‐test for comparison of means Logistic regression |
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| Participants | Pre‐national ban (reported in Fitzpatrick 2009) Census surveys patients (face‐to‐face interviews) 1997 and 1998, Sept 2002, July 2004 census interviews patients Proportional sampling Jan 1998 ‐ staff (face‐to‐face). 2001: (self‐administered questionnaires) Patients (pre‐ban) 1997/1998, n = 711 (combined) 2002, n = 329 Post‐national ban 2004 n = 259 Staff (pre‐ban) 1998,n = 365, 2001, n = 556 Cross‐sectional survey of patients and staff 2006 and 2010 reported in Fitzpatrick 2012. 2006 surveys were post‐national ban and pre‐2009 extension of ban to total campus ban. 2010 surveys were post‐national ban and post‐extension of total campus ban in 2009. Staff surveyed face‐to‐face or by telephone interview. Census survey of inpatients: eligible to participate (all inpatients with exception of day care and those too ill to participate). Written consent obtained prior to face‐to‐face interviews for all surveys. Staff: 2006: n = 225 2010: n = 300 Patients: 2006: n = 295 2010: n = 183 |
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| Interventions | National ban on smoking indoors in public buildings, introduced in March 2004 Total smoke‐free hospital campus policy in 2009. No smoking permitted indoors or outdoors |
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| Outcomes | Smoking prevalence of staff and patients Acceptance of campus ban, beliefs about passive smoking Smoke‐free area in home |
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| Notes | National Ban: Yes, 2004 Smoking banned in general workplace, enclosed public places, restaurants, bars, education facilities, healthcare facilities and public transport. However, it is permitted in designated hotel rooms and there is no ban in residential care, prisons and in outdoor areas Biochemical Verification: Yes. Patients with CO levels > 10 ppm were considered to be current smokers in 2006 and 2010. Staff smoking self‐reported and not validated Follow‐up period: 12 months after total campus ban and 6 years after a national ban |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | High risk | Not applicable |
| Allocation concealment (selection bias) | High risk | Not applicable |
| Sampling bias (selection bias) | Unclear risk | Quota sampling of staff randomly selected representing 10% of staff from each occupational health group. Census survey of inpatients |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | None. Face‐to‐face surveys, except in 2001 when questionnaires for staff were attached to payslips |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Self‐reported smoking status |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Expected outcomes reported |
| Selective reporting (reporting bias) | Unclear risk | Due to small sample size, non‐consultant doctors were merged with consultants to form "medical group" for sampling. Allied services staff and cleaning staff merged for analysis (Fitzpatrick 2012) |
| Other bias | Unclear risk | Other anti‐smoking activities 1997 and 1998 patient surveys were combined for reporting Response rates for staff survey in 2001 was 25% due to alternative administration Validated cotinine available for patient survey 2006 |