Claire Dawson
It may be hard to imagine now, but there was a time when smoking in hospitals was commonplace. From the late 1800s until the early 1990s, tobacco was a fixture of American hospitals, with doctors and nurses smoking during patient examinations, diagnoses, and even in operating rooms. Hospital gift shops sold cigarettes, and smoking lounges were common. Today, the idea of smoking in a hospital seems absurd, but it highlights how cultural norms and health knowledge have evolved over time. This evolution has led to a shift in hospital practices, with smoking now banned in healthcare facilities due to the health risks and fire hazards associated with smoking.
| Characteristics | Values |
|---|---|
| Smoking in hospitals | From the late 1800s until the early 1990s, tobacco was a routine part of the American hospital landscape. |
| Who smoked in hospitals | Doctors, nurses, and patients. |
| Where did they smoke | Doctors might smoke while delivering a diagnosis or in the operating room. Some hospitals had designated smoking lounges next to patient rooms. Patients smoked in their rooms, and doctors and nurses smoked at the nurse's station. |
| Smoking culture | Doctors smoked pipes and cigars, while nurses smoked cigarettes. Hospitals sold cigarettes to patients in bed, and ashtrays were provided on each patient's nightstand. |
| Health concerns | In the 1930s, consumers complained about "smoker's cough" and "smoker's hack," which researchers began to link to cancer. |
| Smoking bans | Smoking bans in hospitals began to be implemented in the 1970s and 1980s, with a federal law banning smoking in hospitals in the early 1990s. |
| Current situation | Smoking is no longer allowed in hospitals. It is considered a significant health risk due to fire potential and the harm caused to patients, especially those with respiratory issues. |
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What You'll Learn
Smoking in hospitals was once commonplace
In the 1970s, it was common for patients to have ashtrays on their nightstands, and hospitals often provided 'state tobacco' for psychiatric patients who could not afford their own. Some nurses recall starting to smoke due to peer pressure, with smoking being the social norm in hospitals. Job dissatisfaction and stress were also contributing factors, with a study from the late '70s finding that nurses who experienced high levels of job-related stress were more likely to smoke.
Despite the prevalence of smoking in hospitals, health concerns about cigarettes began to receive public attention as early as the 1930s. Consumers complained about "smoker's cough" and "smoker's hack," leading researchers to link cigarette smoke to cancer. Over time, smoking was gradually restricted in hospitals, with designated smoking areas on each floor, then limited to one special area in the building, and eventually, a complete ban in the early 1990s.
Today, smoking is prohibited in hospitals, and it is challenging for patients to smoke, especially those with heavy habits. While some patients may still attempt to smoke in their rooms, it is against hospital rules and poses a significant health and fire risk.
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Doctors and nurses smoked while treating patients
From the late 1800s until the early 1990s, tobacco was a routine part of American hospitals. Doctors would smoke cigars or pipes while delivering diagnoses or performing operations. Nurses, too, smoked routinely, at the nurse's station, during reports, while organising med carts, and even with their patients. Some hospitals had designated smoking lounges next to patient rooms.
A respiratory therapist, Dan Carnithan, recalls: "In the 1970s, there was an ashtray on every patient's nightstand. The gift shop sold cigarettes with matches. Sounds bizarre now, but that was the way it was back then!" Jan Potter, a former smoker, recalls that in the 1980s, despite an official ban on staff smoking in common areas, she and her colleagues would smoke anyway.
In the 1930s, health concerns about cigarettes began to receive public attention, with researchers linking cigarette smoke to cancer. However, tobacco companies fought back with advertising campaigns. It wasn't until the 1960s and 1970s that the percentage of female nurses who smoked grew significantly, influenced by campaigns targeting the women's liberation movement. During this time, medical TV shows also depicted doctors and nurses smoking while on duty.
Today, doctors and nurses who smoke can influence the quality of patient care. A meta-analysis suggested that doctors who smoke are less likely to advise patients to quit smoking, and the same is true for nurses. As trusted sources of health information, doctors and nurses who smoke may be inhibited from providing effective counselling on quitting.
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Hospitals sold cigarettes to patients
It may be hard to believe, but there was a time when smoking was a routine part of the American hospital landscape. From the late 1800s until the early 1990s, doctors and nurses were often seen smoking cigars, pipes, or cigarettes while on duty, even in operating rooms and patient rooms. This was a time when smoking was considered glamorous and socially acceptable, and cigarettes were not widely viewed as the harmful, addictive substances we know them to be today.
During those years, it was not uncommon for hospitals to sell cigarettes to patients, with vending machines and concessions stocking tobacco products. Patients could even purchase cigarettes from their beds, with hospital staff delivering them on carts alongside other amenities like chewing gum, toiletries, and books. Some hospitals provided ''state tobacco'' for patients who couldn't afford their own, and in psychiatric hospitals, staff would roll cigarettes for patients who couldn't roll their own.
The culture around smoking in hospitals was so pervasive that even designated smoking lounges were commonly found next to patient rooms. It was not unusual for a compassionate nurse to hold a cigarette to a dying patient's tracheotomy tube, allowing them one last puff. The presence of ashtrays in patient rooms was also common, with some hospitals providing ashtrays bearing their logo.
However, as early as the 1930s, health concerns about cigarettes began to emerge. Researchers started to link cigarette smoke to cancer and other respiratory illnesses. This prompted hospitals to reevaluate their policies, and by the 1960s, some hospitals had begun to prohibit or discourage cigarette sales and smoking on their premises. Despite this, many hospitals were hesitant to implement outright bans, fearing that it would deter patients' recovery or add to the emotional and psychiatric problems of certain patients.
Today, the idea of smoking in hospitals or selling cigarettes to patients seems absurd. The tide has turned, and smoking is now rarely tolerated in hospitals, with many campuses becoming entirely smoke-free. New nurses who smoke may even find it challenging to secure employment, and smoking among healthcare professionals is heavily stigmatized.
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Patients smoked in their rooms
Smoking in hospitals has come a long way from being a routine part of the American hospital landscape to being banned entirely from hospital campuses. While it is absurd to think about smoking in hospitals today, it was a common practice in the past. From the late 1800s until the early 1990s, tobacco was a normal part of hospital life, with doctors smoking cigars or pipes while delivering diagnoses or even during surgeries. Hospitals had designated smoking lounges next to patient rooms, and it was common for patients to smoke in their rooms.
In the 1970s, it was common for patients to have ashtrays on their nightstands, and hospitals even sold cigarettes to patients in bed. Some hospitals provided 'state tobacco' for patients who couldn't afford their own, and staff would roll cigarettes for those who couldn't roll their own. Despite an official ban on staff smoking in common areas, it was a regular occurrence, and patients would ask for partially smoked cigarettes from staff members.
Even as late as the mid-1980s, patients were allowed to smoke in common areas in state psychiatric hospitals. However, by the early 1990s, smoking was banned entirely from hospitals, and today, it is not allowed anywhere on hospital campuses. While it may seem unthinkable now, smoking in patient rooms was a common practice in hospitals for many decades.
While smoking is no longer allowed in hospitals, it is interesting to look back on the practices of the past and consider how perspectives on smoking and health have changed over time. Today, smoking is recognized as a significant health risk, especially in hospitals, due to the fire hazard it poses and the potential harm to patients with respiratory issues.
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Health risks and fire hazards of smoking in hospitals
Smoking is the practice of inhaling smoke from burning plant material. It can cause serious heart and lung diseases, cancer, stroke, heart attack, lung disease, and other health issues. In the United States, more than 490,000 deaths are attributed to cigarette smoking and exposure to secondhand smoke. Cigarette smoke contains more than 7,000 chemicals, at least 69 of which are known to cause cancer. Smoking is directly responsible for approximately 90% of lung cancer deaths and 80% of deaths caused by chronic obstructive pulmonary disease (COPD). It is also a leading cause of congenital malformations (birth defects) in babies born to women who smoked while pregnant.
From the late 1800s until the early 1990s, tobacco was a routine part of the American hospital landscape. Doctors might smoke cigars or pipes while delivering a diagnosis or even while in the operating room. Nurses routinely smoked in the nurse's station, during report-writing, while organizing med carts, and sometimes with their patients. Some hospitals had designated smoking lounges next to patient rooms.
The health risks of smoking in hospitals are similar to those of smoking in any other setting. However, the presence of patients with compromised immune systems or respiratory issues means that the impact of secondhand smoke could be more severe. In addition, the stress and pressure of working in a hospital can contribute to healthcare workers taking up smoking.
Smoking materials are the leading cause of fatal fires in the United States, causing approximately one-quarter of home fire deaths. Hospital fires started by smoking materials fell by 96%, from 3200 in 1980 to 130 in 1998, following the introduction of smoking bans. Smoking bans in hospitals not only protect health but also reduce the risk of fires.
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Frequently asked questions
Yes, smoking was legal in hospitals in the past. From the late 1800s until the early 1990s, tobacco was a routine part of the American hospital landscape. Doctors would smoke cigars or pipes while delivering diagnoses or even during operations. Some hospitals had designated smoking lounges next to patient rooms.
Smoking was extremely common among hospital staff, including doctors and nurses. In fact, it was considered normal for staff to smoke at the nurse's station, during report writing, while organizing med carts, and even with their patients.
While smoking was prevalent in hospitals, there were some restrictions in certain areas. For example, smoking was not allowed in the presence of oxygen due to the risk of fire.
It appears that smoking in hospitals was phased out gradually. By the 1980s, some hospitals had implemented smoking bans in common areas for staff, and by the early 1990s, smoking was banned entirely in hospitals.
Smoking is no longer permitted in hospitals, and patients are not allowed to smoke in their rooms due to the health risks and fire hazards associated with smoking. However, some patients may be permitted to smoke in certain areas with special permission or a doctor's order.
