Smoking near hospital entrances occurs frequently despite smoke-free policies, resulting in multiple issues including second-hand smoke exposure (SHS) to vulnerable populations. Primary school children were engaged through their health curriculum to produce anti-smoking audio recordings for broadcast over a hospital entrance loudspeaker system to determine if this reduced smoking.
Students produced original recordings against hospital grounds smoking during class workshops, from which a collection (n=16) was selected. Episodes of entrance smoking and total entrance traffic were recorded using security-camera infrastructure over a 5-week period. A computer-controlled entrance loudspeaker played a message which was followed by silence until a new (different) message was played. Intensity of messaging was moderate in week-3 (every 5-minutes), increasing to high in week 4 (3-minutely) and compared to no-messages (weeks 1-2 pre-intervention) and week 5 (post-intervention).
Smokers presented 316 times, smoking 523 cigarettes over 155-hours of observation (patients 70.6%, visitors 29.4%). SHS exposure was high given 172 others used the entrance/hour. Smoking was highest in the pre-intervention period (weeks1-2), median 5 cigarettes/hr [IQR,3-7(min=0,max=12)], falling to 4 cigarettes/hr during 5-minutely broadcasts [IQR,2-5(min=1,max=14)] (p=0.06), but zero cigarettes/hr during 3-minutely broadcasts [IQR,0-1(min=0,max=7)](p<0.0001). Post-intervention (no broadcasts), smoking increased from zero to 1 cigarette/hr [IQR,0-3 (min=0, max=5)]; (p=0.052). Non-smoker movements did not change significantly between each period.
Intensive (3-minutely) broadcasting of short anti-smoking messages significantly reduced hospital entrance smoking. SO WHAT?: Health services can positively interact with the health curriculum of primary schools against tobacco use whilst developing low-cost strategies to effectively deter entrance smoking.

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