When Iowa Health – Des Moines put the word out in June to employees about its plans to make its hospitals and clinics entirely tobacco-free on July 1, 2006, a few workers thought there must have been a mistake on the date.

“They said, ‘Did you put the wrong year on this?’” said Sue Allyn, Iowa Health’s vice president for human resources and education. “They couldn’t believe that we were giving them a year’s notice.”

Iowa Health and Greater Des Moines’ two other major hospital groups, Mercy Medical Center and Broadlawns Medical Center, will institute tobacco-free policies that, with the exception of a few leased clinic buildings, will completely eliminate smoking areas on the grounds at each of the hospitals and clinics they operate.

Providing a one-year notice has helped make the move toward tobacco -free health facilities easier, said Allyn, who represents Iowa Lutheran Hospital, Iowa Methodist Medical Center, Blank Children’s Hospital and Iowa Health’s clinics.

Not everyone’s happy with the upcoming ban, of course.

A smoking employee of Iowa Methodist, who asked to remain anonymous, said the new policy will make life difficult for both employees and visitors who smoke.

“I have a hard time telling someone who has a relative or loved one who’s been traumatized that they can’t go outside and have a cigarette while they’re waiting to find out the status of their loved one,” said the employee, who said he has smoked for more than 50 years and doesn’t plan to quit.

“I understand (administrators) feel they have our best interests at heart as far as health conditions are concerned,” he said, “but I just can’t see how they think it’s going to work 100 percent.”

A key component of the program at each hospital has been smoking-cessation classes, according to human resource administrators at each of the three hospital groups. Employees who successfully complete the eight-week, voluntary classes will be reimbursed the $25 fee for the class, Allyn said.

“And a lot of people have taken it upon themselves to quit on their own without signing up for classes,” she said.

Des Moines University, a medical school that trains osteopathic physicians and podiatrists, also plans to make its campus tobacco-free on July 1.

“To my knowledge, we’re the first (higher education) campus in the state to go smoke-free,” said Diane Langner, a benefits administrator at DMU and head of its tobacco-free committee. Langner said the university was approached by the hospitals last summer to join in their initiative, but wasn’t ready to so at the time.

DMU, which had prohibited smoking near building entrances, on Oct. 1 established a handful of designated outdoor smoking areas, and announced its plans to go completely smoke-free next summer. Its next-door neighbor, the Wesley Acres retirement community, will also go smoke-free July 1.

According to data published Nov. 10 by the Centers for Disease Control and Prevention, just under 21 percent of U.S. adults, or 44.5 million, smoke, down from 21.6 percent in 2003. The CDC implemented its own tobacco-free campus policy on Nov. 17, which was the 29th annual Great American Smokeout.

Tobacco use among adults and exposure to secondhand smoke in Iowa continue to be major public health problems, according to the Iowa Department of Public Health. Estimated annual health-care expenditures in Iowa directly related to tobacco use total $617 million.

About 11 Iowa hospital groups are now at some phase making their campuses tobacco-free, said Julie Tabatabai, a cardiopulmonary nurse and smoking cessation counselor at Grinnell Regional Medical Center, which became tobacco-free on Nov. 17. As a project for her master’s thesis, Tabatabai has coordinated meetings for hospitals statewide through the Iowa Cancer Care Consortium to present administrators with model policies endorsed by the Iowa Hospital Association.

“We encourage health-care organizations to join forces within their community to implement the policies on the same day,” she said. “You don’t want to be known as the ‘smoking hospital,’ and you don’t want people jumping ship to another hospital (because one allows it).”

Will campus-wide bans be workable?

“I think all policies have to be revisited,” Tabatabai said. “What makes hospitals unique is that you have three groups to work with: visitors, patients and staff.”

It’s possible there may be exceptions for patients that aren’t built into the policies. For instance, she said, “a physician might write an order that a terminally ill patient who smokes be allowed go outside with family to smoke.”

Des Moines hospital administrators said positive comments about the tobacco ban have outnumbered negative comments.

“I think we have 10 positives for every one concern,” said Robyn Wilkinson, Mercy’s chief human resources officer. “And the negatives have been more, ‘How are we going to manage it?’ rather than it not being the right thing to do.”

The no-smoking rule will be enforced just like any other policies are, Wilkinson said. “And it won’t be just security officers enforcing it,” she said. “We rely on all of our employees to enforce our policies.” Employees who continually break the rule will be fired, she said.

Hospital security personnel will enforce the policy with patients and visitors outside the buildings, she said. “We won’t be walking up to people’s cars if they’re smoking, but there will be signs posted saying there is no smoking in the parking lot.”

Vermeer Manufacturing Co. to go tobacco-free on Dec. 26

Going to an entirely tobacco-free campus will be a “natural progression” for Vermeer Manufacturing Co., said Terry Butler, director of environmental health and safety for the Pella-based company.

The company, which employs 1,900 people, plans to adopt a tobacco-free policy on Dec. 26, after moving smokers and chewing tobacco users outside to designated areas two years ago. At that time, as many as 45 percent of Vermeer employees were tobacco users, Butler said. “It’s probably about 30 percent now,” he said. “We’ve had a lot of people quit (tobacco) by taking advantage of the smoking cessation programs.”

Employees won’t be allowed to leave the campus to smoke during breaks, but will be allowed to leave in their vehicles during lunch time to smoke if they want, Butler said.

“It really gets down to that we care about the health of our employees,” he said. “The evidence of how smoking shortens people’s lives is too compelling to ignore. We believe strongly in providing an environment that’s tobacco-free.”