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Our study suggests that female staff, younger staff, non-clinical staff, and staff who were non-smokers may benefit from studies identifying barriers and using targeted programs to boost their comfort level in discussing smoking to further protect patients/families and create a healthier work environment.

FUNDING This study was supported in part by research grants from the National Natural Science Foundation of China (Project approval number: 82070668)

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In response to a questionnaire that the National Association of Tax Administrators sent to the states in 1985, Michigan indicated that its negotiations with tribal leaders had "ended the Indian smokeshop problem."[83] A 2006 report from the state Treasury Department recounted the success of the negotiations: [T]he Department of Treasury has committed significant time and resources toward establishing relationships with the various Michigan tribes and developing specific protocols to help guard against the inappropriate distribution of untaxed cigarettes