Introduction:
The Catalan Institute of Oncology (ICO) implemented the intervention "Moving Away Tobacco" to extend smoke-free spaces beyond the entrances of hospitals in 2021. The objectives were 1) to implement and evaluate the impact of the intervention in the ICO Campus, and 2) to reinforce the tobacco control role of ICO staff.

Material and Methods:
ICO Campus hosts several health and research institutions. The intervention consisted of 1) before implementation: institutional commitment, action plan definition, signposting of entrances beyond the Campus, communication campaign and baseline assessment of compliance indicators; 2) implementation: kick-off (May 31st, 2021) with media coverage; and 3) evaluation of the compliance: two post-implementation assessments of indicators in the extended areas, such as butts on the grounds, number and characteristics of people smoking in the main entrances, and a survey to assess staff’s opinion about the intervention.

Results:
We obtained a high level of commitment from the institutions during the design process. Entrances were signposted explaining the extension of the smokefree area ( 5m). The follow-up assessments (Oct 2021 & May 2022) showed an improvement of indicators. The presence of tobacco butts on the ground entrances decreased by 58.0% and by 50.0%, number of staff smoking decreased by 97.2% and by 88.9%, and number of patients/visitors smoking decreased by 73% in both assessments. The satisfaction of staff was very high and 98% supported the intervention.

Conclusions:
This intervention goes beyond the current legislation by promoting smoke-free spaces beyond the hospital premises. Managers and staff supports the intervention, and compliance with the smoke-free spaces slightly attenuates over time. Continuous turnover of patients and visitors has been identified as the main barrier. Strengthening enforcement by improvement of communication and signalling is warranted, together with continuous monitoring of indicators.