Search tips
Search criteria 


Logo of pubhealthrepPublic Health Reports
Public Health Rep. 1996 Jan-Feb; 111(1): 66–70.
PMCID: PMC1381745

Resident smoking in long-term care facilities--policies and ethics.


Objective: To characterize smoking behavior, facility policies related smoking, and administrators' views of smoking-related problems in Veterans Affairs nursing home care units nationwide. Methods: An anonymous mail survey of long-term care facilities was administered to 106 nursing home supervisors at VA Medical Centers with nursing home care units. The response rate was 82%. Results: Administrators from 106 VA nursing home units reported smoking rates ranging from 5% to 80% of long-term care residents, with an average of 22%. Half of the nursing homes had indoor smoking areas. Frequent complaints from nonsmokers about passive smoke exposure were reported in 23% of the nursing homes. The nursing administrators reported that patient safety was their greatest concern. Seventy- eight percent ranked health effects to the smokers themselves a "major concern," while 70% put health effects to exposed nonsmokers in that category. Smoking in the nursing home was described as a "right" by 59% of respondents and a ¿privilege¿ by 67%. Some individuals reported that smoking was both a right and a privilege. Conclusion: Smoking is relatively common among VA long-term care patients. The promotion of personal autonomy and individual resident rights stressed in the Omnibus Budget Reconciliation Act of 1987 may conflict with administrative concerns about the safety of nursing home smokers and those around them.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Rimer BK, Orleans CT, Keintz MK, Cristinzio S, Fleisher L. The older smoker. Status, challenges and opportunities for intervention. Chest. 1990 Mar;97(3):547–553. [PubMed]
  • Omenn GS, Anderson KW, Kronmal RA, Vlietstra RE. The temporal pattern of reduction of mortality risk after smoking cessation. Am J Prev Med. 1990 Sep-Oct;6(5):251–257. [PubMed]
  • Dobson AJ, Alexander HM, Heller RF, Lloyd DM. How soon after quitting smoking does risk of heart attack decline? J Clin Epidemiol. 1991;44(11):1247–1253. [PubMed]
  • Aronow WS, Starling L, Etienne F, D'Alba P, Edwards M, Lee NH, Parungao RF. Risk factors for coronary artery disease in persons older than 62 years in a long-term health care facility. Am J Cardiol. 1986 Mar 1;57(8):518–520. [PubMed]
  • Rogers RL, Meyer JS, Judd BW, Mortel KF. Abstention from cigarette smoking improves cerebral perfusion among elderly chronic smokers. JAMA. 1985 May 24;253(20):2970–2974. [PubMed]
  • Hirdes JP, Maxwell CJ. Smoking cessation and quality of life outcomes among older adults in the Campbell's Survey on Well-Being. Can J Public Health. 1994 Mar-Apr;85(2):99–102. [PubMed]
  • Fahy RF, Tremblay KJ, Barry JJ., 3rd The catastrophic fires of 1989. Fire J. 1990 Jul-Aug;84(4):60–79. [PubMed]
  • Demers DP. 25 die in nursing home. Fire J. 1981 Jan;75(1):30–35. [PubMed]
  • Drinka P. Nursing home residents who are unsafe smokers and require supervision while smoking. J Am Geriatr Soc. 1994 Jun;42(6):689–689. [PubMed]
  • Brownson RC, Alavanja MC, Hock ET, Loy TS. Passive smoking and lung cancer in nonsmoking women. Am J Public Health. 1992 Nov;82(11):1525–1530. [PubMed]
  • Greer JR, Abbey DE, Burchette RJ. Asthma related to occupational and ambient air pollutants in nonsmokers. J Occup Med. 1993 Sep;35(9):909–915. [PubMed]
  • Joseph AM. Is Congress blowing smoke at the VA? JAMA. 1994 Oct 19;272(15):1215–1216. [PubMed]
  • Parks JJ, Devine DD. The effects of smoking bans on extended care units at state psychiatric hospitals. Hosp Community Psychiatry. 1993 Sep;44(9):885–886. [PubMed]

Articles from Public Health Reports are provided here courtesy of SAGE Publications