New VA Smoking Policies Too Weak

Posted on October 1, 2012

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The U.S. Department of Veterans Affairs (VA) provides lifelong healthcare to our nation’s military veterans. Commonly referred to as VA hospitals, these facilities have historically been neglected infrastructure. Although over the past ten to fifteen years, the Federal government has invested heavily in updating, replacing, and expanding military and VA facilities.

The Federal government’s record on design and construction projects has been spotty.  Earlier this year the General Services Administration (GSA), which provides a lot of support functions, especially related to procurement and purchasing, had its infamous Las Vegas soiree black eye.  Budget and schedule overruns on VA projects are legendary, and by margins that would put most companies out of business as well as get entire teams fired.  No one has ever accused the government of running a lean operation, in healthcare or anything of which I am aware.

However, the Fed has been progressive in its commitment to sustainability—in some cases, forcing adoption of LEED for government projects, and helping to amplify the adoption and relevance of LEED in the private sector as well.

One aspect the Federal government falls woefully short on, which I feel is hypocritical given it goes hand-in-hand with its strong sustainability stance, is smoking at healthcare facilities.  The Bay Pines VA facility outside St. Petersburg, FL, released new stricter regulations regarding tobacco on campus:  ‘no smoking indoors or outdoors—except in designated locations’.  That last escape clause eviscerate the entire revision.  In fact, it pretty much makes the new reg’s meaningless.

For the record, the Bay Pines VA limits patient smoking to seven outdoor spots on its campus; for employees, ten spots.  That’s seventeen separate spots that non-smokers could encounter smokers.  This particular VA campus has several buildings, but ten spots,…outdoors,… in Florida?  Most of the country might find that a reason to start smoking…not exactly a policy with teeth, as they say.

Compared to non-government healthcare providers (both for-profit and non-profit), the VA is in the Dark Ages in its stance on tobacco at the hospital.  Many hospitals and systems have been banning smoking entirely on campuses—patients, employees, visitors—for years.  The Cleveland Clinic does not even hire smokers, and that has been in effect since 2007.  Hospitals and systems in more than a dozen states have followed suit since.  Nineteen states allow employers to screen job applicants for smoking, so this intervention is not going away.

Reform in healthcare food service is already under way, bringing more thoughtful, heart-friendly diet choices that better mesh with recuperation, and that makes sense.  Today, air quality expectations are high.  Smoking, long in the public’s crosshairs, should be universally banished everywhere people are in a weakened physical condition and charged with the task of getting better. 

Wellness is difficult enough to achieve with 100% effort from patient and staff; we don’t need to handicap it. The Federal government and VA need to take a hard-line on this issue for the betterment of public health and its veterans—and it won’t even cost tax payers a penny to do so, so there is no excuse.

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