While it is fine to declare yourself "pro-choice" when it comes to facilitating smoking at a healthcare facility, the PPAO has never outlined how they would deal with the intractable ethical, health and safety and operational issues (outlined in detail in the article) that come with this stance. They also continue to confuse "consultation" with "majority rule." All of our patients were consulted about the change, but it is the hospital administration's moral and legal duty to provide a safe and therapeutic environment whether the majority of patients disagree with some of the rules or not.

Recent court decisions resulting directly from legal challenges to our policy clearly stated three things: there is no right to smoke enshrined in Canadian law; not allowing patients to smoke is not forced treatment; and the health and safety of the entire hospital community supersedes any claim to residential smoking privileges. There are many hospitals, nursing homes, healthcare facilities and even universities in Canada that have banned smoking on their campuses or are considering making this change for reasons similar to ours. We know this because many have contacted us for information and guidance.

We have not turned a "blind eye" to the dangers of smoking contrary to policy. Anyone who runs a hospital - whether it allows limited smoking or not - is aware that policy violators endanger everyone and works to counter the risk.

We could go on, but let's just address the final point: Are we successful? Reports from our medical staff indicate that the patients are definitely healthier. We no longer devote significant resources to facilitating a harmful activity. Many staff and patients have expressed their relief that they are no longer exposed to cigarette smoke. We call that a success.