by Greg Nikkel of the Weyburn Review
Staff on D Unit of Souris Valley Extended Care Centre are hoping to extend the success of a stop-smoking campaign with its patients, which has seen two-thirds of the smokers in the unit quit the habit.
The staff began on Nov. 1 to encourage the last remaining smokers to quit the habit if they can, and will be trying to help them to do so.
Before the South Central Health District implemented its district-wide non-smoking policy two years ago, most all of the patients, and many of the staff, on D Unit smoked, making the activity room's air virtually blue with haze.
When the district implemented its policy, the unit was granted a one-year extension to gradually reduce the level of smoking by the patients, said Marga Cugnet, vice-president of patient services for the health district.
The reason for the phase-in, added unit nurse manager Anita Twarowski, is the patients in D Unit are long-term chronic schizophrenic patients, most of whom were residents of the old Saskatchewan Hospital. Most have been residents for many, many years, with some residing there for as long as 60 years.
The practice in the old hospital was to use the handing out of cigarettes as a reward for good behaviour, said Twarowski.
"Most of the residents have been there so long that everything is a routine. Cigarettes were basically used as a reward, and they learned to line up for their cigarettes," she said, adding that when the smoking policy came in, they established a smoking area and times when residents could smoke.
"We gradually decreased them. Eleven of them went from 10-12 cigarettes a day down to four or five a day, and 14 went down to seven a day. Six of them only came when they wanted to," said Twarowski. The initial group of smokers numbered 32, and today there is a group of 10 who still smoke, but now do so outside, along with the staff. Two residents quit smoking altogether at the start.
Marga Cugnet, SCHD vice-president of patient services, acknowledged using cigarettes as a reward was the practice in the unit until the smoke-cessation program began.
"What we've been doing is working towards providing no-smoking programs. It's a reversal of using cigarettes as a reward. We're trying to encourage the patients to stop smoking," she said.
"When this was first instituted, staff were concerned that there would be problems with some of the clients," said Cugnet, adding there was certainly some resistance from some resistance, but some of those who objected the loudest have since cut down or quit altogether.
Part of the program to help the patients reduce smoking involved tightly controlling the supply of cigarettes and limiting the time when they can go out for a smoke. The patients aren't allowed to have matches, so they can't smoke in their bedrooms or bathrooms.
The initiative begun on Nov. 1 to help the last remaining smokers quit will be tried, but Twarowski admits there may be three or four who may never be able to quit the habit completely. One of the problems they've encountered, she said, is seven of the group of 10 work outside at the Wor-Kin Shop, where fellow workers who live in group homes also smoke.
Twarowski and her staff say no one has been forced to quit smoking, but the staff is working hard to try and provide alternatives for the patients who do give up the habit, such as extra treats and activities. Twarowski said some of the staff were quite skeptical when the order first came down to try and cut the smoking down in the unit, but in the time since there has been success.
"We'd like to continue with it. We try and provide lots of activities for them. They don't want to go out (for a smoke) in case they miss activities," said Twarowski.
The decision to implement the far-reaching policy two years ago was not an easy one for the board to make, said Lee Spencer, health district CEO and president.
"This was something the board really wrestled with, it wasn't an easy thing for them to decide. They have a commitment to provide services to those who do smoke as well as those who don't," he said.
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