When Albert Einstein Healthcare Network's Elkins Park campus goes tobacco-free Thursday, it will join the majority of hospitals around the region, including all in South Jersey, that in the last few years have banned tobacco from their entire campuses, including parking lots and sidewalks.
Even some of those that allow some smoking somewhere - though rarely inside - are taking leadership roles on an issue that is often described as a moral imperative for institutions whose mission is health. Abington Memorial Hospital and its various campuses stopped hiring smokers July 1. Roxborough Memorial Hospital this year added a surcharge for employees who receive health benefits if they or their spouses smoke.
"Hospitals want to get in front on this as a health issue," said Bronson Frick, associate director of the Berkeley, Calif., advocacy group Americans for Non-smokers' Rights. They also are trying to hold down the costs of insuring workers, who sometimes smoke at higher rates than people in other professions, perhaps because of stress.
A 2008 national survey by the Joint Commission, which accredits hospitals but does not evaluate campus smoking policies, estimated that 45 percent had banned smoking from every inch of their grounds and predicted that the figure would increase to 60 percent within a year. An Inquirer survey of hospitals in the region found a similar percentage banning tobacco of all kinds.
State law on secondhand smoke has generally banned smoking in hospitals in Delaware for more than 15 years, in New Jersey since 2006, and in Pennsylvania since 2008. Laws rarely extend to the surrounding campuses, and until several years ago smokers could be found around some entrances or huddled in designated outdoor sheds.
Many hospitals still make exceptions - in designated areas - for psychiatric patients, who may have an especially difficult time overcoming a nicotine addiction.
Patients at rehabilitation hospitals are also known to have high rates of smoking. Concerns about those patients' health actually encouraged Einstein, which has not banned smoking at its main hospital campus in Philadelphia, to start with the campus it calls Einstein Medical Center Elkins Park/MossRehab, a joint facility with 66 acute-care beds and 130 in the rehabilitation section, said Lynne R. Kornblatt, the system's vice president of human resources.
For someone with an active lifestyle who suddenly becomes a paraplegic or quadriplegic, she said, smoking is a way to "cope with things that are extremely traumatic."
"I think patients have some resistance to this," Kornblatt said. Some employees also have protested, though she said no one has threatened to quit and there has been an "outpouring from employees" asking that the policy be expanded to other campuses.
That will likely happen eventually, she said, but first officials want to see how the initial move - timed for the American Cancer Society's Great American Smokeout on Thursday - plays out. Einstein's Montgomery Hospital Medical Center, a 146-bed acute-care hospital under construction in East Norriton Township, will be smoke-free when it opens in September.
Meanwhile, employees throughout the system are being offered free smoking cessation, said Kornblatt, a former smoker who had a family member die of lung cancer two weeks ago and, during her years as a nurse, saw patients whose smoking-related diseases led to "horrible, horrible deaths from not being able to breathe."
Besides Einstein, several other major hospital campuses in the city, including Temple and the Hospital of the University of Pennsylvania, are almost but not entirely smoke-free, which Kornblatt attributed to the complexity of large hospitals and concerns about recruiting employees who already face parking and other urban challenges.
That has not been an issue across the river, where hospitals joined together on a campaign that resulted in an entirely smoke-free South Jersey, said Jayson Plaia who worked on the campaign from a regional American Cancer Society office.
As a result of the no-jobs-for-smokers approach taken by Abington Memorial since July 1, offers to five new hires were rescinded when they failed a nicotine test, said spokeswoman Linda Millevoi; 272 hires were made.
Roxborough Memorial on Jan. 1 began a biweekly payroll fee - $12 for workers who smoke, $24 if their spouse does, too - for those who get health benefits. About 10 percent of the 400 eligible employees have chosen to pay, spokesman Michael Henrici said.
He said the hospital put the plan together in consultation with its broker. He would not say how much Roxborough pays for health coverage.
The fee is waived for smokers who provide evidence of entering a cessation program.
"They get three months to quit - after three months, if unsuccessful, the surcharge is levied," Henrici said.
Live chat: Frank Leone, head of smoking cessation at Penn, offers help Thursday at 2 p.m. at www.philly.com/health
Contact staff writer Don Sapatkin at 215-854-2617 or email@example.com.