Chapter 6 232 who were smoking in the smoke-free area. These rounds were prescheduled twice a day for sixty to ninety minutes per round. Data collection During these first two weeks, two observers (JB, JGtB, IB and/or LK) observed the addressors and smokers in the smoke-free zone from a distance. In the next two weeks one observer from the same group acted as addressor, and the other as observer. The observer noted the number of smokers present at short distance of the observers, whether they were addressed and if so, whether this was done directly or indirectly (i.e. smoker was able to overhear another smoker being addressed), the behavioural response to being addressed (positive: extinguishes cigarette or continues smoking outside the smoke-free zone, negative: continues smoking at same location, continues smoking elsewhere inside smoke-free zone) and any verbal response (positive: understanding or happy, neutral: guilty or surprised, or negative: angry, cranky, indifferent, starts discussion). Smokers were not addressed if their cigarette was already extinguished, or when they were on the phone. Any discrepancies among observers regarding the categorisation of responses were discussed immediately until consensus was reached. Any other noteworthy events were recorded in a daily log. Data analysis Smokers were categorised into: patients, employees, students, and others, as described previously.10 Categorical data are shown as numbers and percentages. Differences between groups were assessed using chi-squared tests. Ethical considerations The Medical Ethics Committee of the Erasmus MC declared that the rules of the Medical Research Involving Human Subjects Act (In Dutch: WMO) did not apply to this study (MEC-2019-0585). Results In total, 331 smokers were observed. The majority were classified as patients (39%), employees (22%) or students (21%). Most smokers were addressed directly (73%), others indirectly (10%) or not addressed (17%). Among the latter group, responses were unobservable, and among the former data were missing
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