Gadomski 2010.
| Methods | Country: USA, New York Setting: Hospital Design: Uncontrolled before‐and‐after study (cohort of staff) Analysis: McNemar test and t‐tests |
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| Participants | Employee tobacco use rates from occupational health assessments accessed Percentage patients smoking and NRT orders obtained from electronic records. Number of inpatients who signed out against medical advice obtained from incident records A cohort of 489 staff were surveyed to determine smoking prevalence pre‐ and post‐ban and followed up. March to June 2005 pre‐ban and March to June 2006 and 2007. All hospital employees were also surveyed at 3 points ‐ total N not provided for all employees An average of 959 patients were admitted per month in the 18‐month period pre‐ban and 988 per month in the 23 month post‐ban |
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| Interventions | Smoke‐free medical campus implemented on July 1, 2006, which included an NRT programme and additional signage | |
| Outcomes | Patient and employee smoking prevalence Percentage of inpatient NRT orders, number of inpatients who signed out against medical advice (obtained from incident reports) recorded | |
| Notes | National Ban: Yes, 2003 New York State Smoke‐free Air Act 2002, enacted 2003. Banned smoking in virtually all workplaces and indoor recreational venues. Amendment to the City’s 1995 Smoke‐Free Air Act, the new law banned smoking in all restaurants and most bars regardless of seating and size. The law restricted smoking in some outdoor restaurant and bar seating areas Biochemical Verification: No, staff self reported if smoked or chewed tobacco Follow‐up period: 1 year post‐policy. 2 years follow‐up for NRT prescribing (patients) |
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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 | Data collected on all patients from electronic records, all hospital staff surveyed |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Not applicable |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Self‐reported smoking status. Data obtained from hospital records and annual employee assessment records |
| Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Total number of staff employed not reported |
| Selective reporting (reporting bias) | Unclear risk | Only post‐ban smoking prevalence reported for patients |
| Other bias | Unclear risk | Cessation counsellor works part‐time and access limited No night admissions reviewed by counsellor Self‐reported smoking status No pre‐ban smoking prevalence data for patients |