Situation
Union Hospital, a not-for-profit medical facility, had banned smoking from hospital buildings several years ago, but still permitted employees and visitors to smoke outside the hospital. As a facility whose goal is the health of the community, hospital officials determined that permitting smoking anywhere on hospital property was a deterrent to this goal. In addition, the hospital had been challenged by the public, including an eighth grade class at a local middle school, with complaints about smokers outside the main entrance. Hospital officials decided to ban smoking on all hospital property beginning on July 1, 2005.

Early in the year, a community awareness subcommittee was formed, with Union Hospital spearheading a community-wide smoke-free initiative. The committee included participation from the American Cancer Society, the Vigo County Health Department, C.H.A.N.C.E.S. for Youth, the West Central Indiana Area Health Education Center and Indiana Tobacco Prevention and Cessation.

As a part of the initiative, other businesses also made the decision to go smoke-free. These included AP&S Clinic, HealthSouth Hospital of Terre Haute, Providence Medical Group, Terre Haute Medical Laboratory and West Central Community Hospital.

Problem
Having made the decision to ban smoking on hospital grounds, officials had to then develop a plan to implement that decision. Union Hospital and the other businesses were faced with the challenge of promoting to employees and the public an announcement that for some was very unpopular. Further, the subcommittee needed to create public awareness about the community smoke-free initiative.

Solution
MillerWhite LLC worked with Union Hospital and the subcommittee to set into motion a public relations and marketing campaign.
Union Hospital handled internal communications and public relations, which included earned media placed prior to July 1 to raise awareness of the danger and high cost of tobacco use. Events were part of the public relations effort, including the official smoke-free kick-off at the local Relay for Life and a public health forum presented in April by the Indiana State Department of Health, which included a discussion about efforts to restrict smoking in public areas.

To inform and persuade hospital employees, patients and visitors, MillerWhite designed payroll stuffers ,posters ,political-style yard signs ,banners and shuttle bus static clings, among other materials, to advertise the July 1 smoke-free date. Materials included information on smoking cessation. The payroll stuffers were included with employee paychecks over a two-month period. Versions of these materials were produced for the other businesses also making the change. The theme, “Clearing the Air for the Health of Our Community,” was represented by a bright blue sky with fluffy clouds.

To increase awareness of the community initiative among the general public, MillerWhite created radio spots that ran in late May and heavily through June. A television commercial , which ran prior to July 1, featured members of the eighth grade middle school class that had sent their complaints to the hospital. Print ads were created that ran from late May through June, as well as an American Cancer Society “thank you” ad, which ran the week of July 1.

In support of the initiative to take Terre Haute “A Level Above,” the subcommittee, led by Union Hospital, sought to help other businesses curtail the high costs of smoking by promoting a healthier lifestyle for the citizens of Terre Haute. To provide this assistance, the subcommittee directed MillerWhite to create a tool kit with information on the costs of smoking to employers and on how to implement a smoke-free policy. The kit will be available to download from a special web site.

Results
Visible results of the smoke-free campaign were immediate and dramatic. Individuals are no longer smoking in front of the hospital, and smoking has been virtually eliminated on Union Hospital’s campus. Grounds maintenance crews are spending far less time maintaining and cleaning up the hospital entrances and are able to devote more time to other parts of the campus.

Lorrie Heber, systems director, public relations for Union Hospital Health Group, said that while there was some negative reaction to the change, there has been an overwhelming positive response, with a number of people thanking the hospital for taking the lead in the smoke-free effort. “Most significantly,” Heber said, “More than 350 employees have requested smoking cessation assistance, aids or counseling.”