06-1 Smoke-free policies for hospital accreditation Hospital accreditation: smoke-free criteria In accordance with their national authorities, most European hospitals are in accreditation process. The inclusion in national accreditation guidelines of smoking-free criteria is effective in reinforcing the promotion of smoke-free policies.

06-2 Smoke-free policies for hospital accreditation 3 criteria are proposed to be included in hospital accreditation guidelines 1. Hospital defines and implements a smoke- free policy. 2. Hospital provides help and assistance to smokers willing to cease smoking. 3. Measures to insure the prohibition of tobacco smoke are included in fire prevention procedures/guidelines

06-3 Smoke-free policies for hospital accreditation General policy for Smoke-free Hospitals Hospitals define and implement a smoke-free policy. l The implementation of a smoke-free policy described in this guideline is based on the Smoke-free Hospital European code. It provides a way to comply with the requests from the accreditation board on this criteria. At the beginning, a good implementation plan is more important than the results.

06-4 Smoke-free policies for hospital accreditation Providing help and assistance to smokers willing to cease smoking In and out-patients receive health education information on smoking prevention and help towards smoking cessation. All smoking patients must receive educational and preventative education that invites them to refrain from smoking with or without substitution during their hospital stay. Nicotine Replacement Therapy that stops smoking either definitely or temporarily needs to be organised.

06-5 Smoke-free policies for hospital accreditation Fire prevention Tobacco control measures need to be closely related to fire prevention measures. Fire prevention is under the responsibility of hospital management and staff. The legal responsibility of management has been clearly designated in several deadly fire-accidents stemming from cigarettes.

06-6 Smoke-free policies for hospital accreditation ENSH Letter to European Health Ministers Dear Sir, During the latest meeting of the European Network of Smoke-free Hospitals, it appeared to the twelve participating countries that European hospitals were, at various stages, under accreditation procedure, but only one country (France) included smoking criteria. The French experience, which included three smoking criteria in hospitals’ accreditation procedure, shows the efficiency of such simple measures. The three criteria concern:  Implementation of a smoke-free policy within the hospital (European Code herewith included);  Providing help and assistance to smokers willing to cease smoking;  Fire safety. We would be very much interested in knowing if you have already started such a procedure, of which we have not yet been informed, or if you plan to implement it in the near future. May 31 st, International Tobacco-free day, would be a symbolic date in order to announce such a measure within your country.