If you want to smoke cigarettes or chew tobacco at Sunrise Hospital, you'll have to go somewhere else.

No, not outside the entrance.

And not in the parking lot, either. Not even if you're sitting in your car.

In fact, if you merely smell like cigarette smoke, forget about getting inside the hospital. Tobacco is taboo as of July 1 at Sunrise and Sunrise Children's Hospital, under a policy that nearly 80 percent of the hospitals' employees asked for in a recent survey.

"This effort aligns directly with our mission to improve the health of the community," said Sylvia Young, president and chief executive officer of Sunrise and Sunrise Children's Hospital, in a statement. "This change is the result of an overwhelming request from our employees to make our campus tobacco-free."

Sunrise's tobacco ban came just two weeks after Gov. Brian Sandoval signed a bill relaxing the state's voter-approved prohibition on smoking cigarettes in public. The law followed a push by the Nevada Tavern Owners Association, which said the 2006 smoking cigarettes ban hurt business.

The new law doesn't jibe with broader trends in smoking cigarettes policies across Nevada and the nation, as businesses and government agencies crack down on tobacco use among employees and customers alike. Public-health experts say the state's weakened smoking cigarettes ban is unusual, and unlikely to stop the anti-smoking cigarettes crusade's advance.

SIMILAR POLICIES

For starters, Sunrise isn't the only local hospital operator with strict no-smoking cigarettes regulations.

Valley Health System's Centennial Hills Hospital was the state's first smoke-free hospital when it opened in January 2008, said company spokeswoman Gretchen Papez. Since then, the company's four other area hospitals -- Desert Springs, Spring Valley, Summerlin and Valley -- have all banned smoking cigarettes everywhere on-site, including parking lots. The prohibition applies to employees, patients, doctors, vendors, contractors and visitors.

And St. Rose Dominican Hospitals went smoke-free at its three Southern Nevada campuses in July 2009. To ease the transition for smokers, St. Rose Dominican's insurance plans cover smoking cigarettes-cessation benefits. The operator also offers free cessation programs online, along with telephone coaching and a six-week supply of quitting aides such as nicotine gum. Visitors receive "Kraving Kits" with nicotine candy, gum and straws to fight the smoking cigarettes urge.

HEALTH COSTS A FACTOR

Smoking's financial toll is driving the growing number of smoke-free workplaces, said Maria Azzarelli, tobacco control coordinator for the Southern Nevada Health District.

Figures from the agency, which itself went completely smoke-free in March, show that the 22 percent of Nevadans who light up create $565 million a year in health costs directly related to smoking cigarettes. The state's Medicaid program covers $123 million of that expense, but employers and their insurance programs pick up much of the rest. What's more, smoking cigarettes costs the state's employers more than $900 million a year in lost productivity.

"Employees who smoke cigarettes miss more days of work due to illness, and that costs a company money," Azzarelli said.

And then there's the image factor.

Health-care businesses have embraced smokeless offices because going tobacco-free fits the prevention and wellness message they want to advertise.

"St. Rose is committed to the promotion of quality health care, which includes the prevention of disease," said Laurel Helfen-Larden, the hospitals' manager of injury prevention and wellness. "All medical evidence indicates smoking cigarettes or tobacco use is contrary to this objective. It is recognized that not smoking cigarettes or using tobacco on campus is a challenge for staff and physicians. The scope of this policy is intended to support and encourage ownership of a commitment to promote health."

Even non-health companies care more these days about what potential customers see before they walk through the door.

The health district's minimum-distance campaign, which encourages business owners to prohibit smoking cigarettes within 30 feet of their building's entrance, is increasingly popular, Azzarelli said. The agency hasn't closely tracked interest in the program, but anecdotally, the number of companies requesting minimum-distance signs is rising, she said.

There's also a group working to ban all tobacco use on campuses of the University of Nevada, Las Vegas, Nevada State College and the College of Southern Nevada.

Susan VanBeuge, a UNLV assistant professor and coordinator of the school's doctor of nursing program, heads the effort, which is being funded in part by a federal grant from the Centers for Disease Control and Prevention. VanBeuge said a policy should be in place by Jan. 1, with implementation phased in through 2012.

Like Sunrise, UNLV conducted a survey on tobacco use on campus. The September poll found that 65 percent of students wanted tobacco products banned from the school.

"This (tobacco-free environments) is definitely a trend in the U.S.," VanBeuge said. "I'm a nurse practitioner. I feel very committed to creating a positive, healthy environment for those who work on our campus, as well as those who are students or who are visiting our campus. We want to model and promote healthy lifestyles."

STATUTORY 'ANOMALY'

But that goal seems at odds with the Nevada Legislature's relaxing of the state's smoking cigarettes ban.

Azzarelli called the Legislature's move an "anomaly" in an era when most Americans -- and Nevadans -- want less smoking cigarettes in public places. Fifty-four percent of the state's voters approved of the ban when it was on the 2006 ballot.

"The people very clearly stated that they were progressive on this issue, and wanting to move forward like the rest of the nation and the world," Azzarelli said. "I do think it (the weaker ban) was odd. That really hasn't happened in any other community. But it's very clear that special-interest groups made it happen. It wasn't the public. People overwhelmingly understand the dangers of secondhand smoke, and they want to be protected from secondhand smoke cigarettes in public places."

In some states surrounding Nevada, anti-smoking cigarettes policies are even tougher: As of July 1, insurer Humana no longer hires tobacco users in Arizona. Humana rolled out a similar rule in Ohio in 2009.

But Humana spokesman Ross Mc­Lerran said such a policy is unlikely in Nevada, because it's one of 29 states that make it illegal to discriminate against smokers in hiring.

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