News Release

Majority of US hospitals will have smoke-free campuses by end of year

Non-profit hospitals more likely to have smoke-free campuses than for-profit entities

Peer-Reviewed Publication


WASHINGTON DC, Aug. 20, 2009—While hospital buildings are often smoke-free, a new study finds that by February 2008, 45 percent of US hospitals had adopted "smoke-free campus" policies, meaning that all the property owned or leased by the hospital, both indoors and outdoors, was smoke-free and there were no designated smoking areas on those properties.

The study, "The Adoption of Smoke-Free Hospital Campuses in the United States," is the first of its kind to examine the national prevalence of smoke-free hospital campus policies. It was conducted by The Joint Commission, the world's largest healthcare standards setting and accrediting body, and researchers from the Henry Ford Health System's Center for Health Promotion and Disease Prevention. The study was funded by the Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation and appears in the online version of the peer-reviewed journal Tobacco Control.

"Besides the 45 percent that already had smoke-free campuses, another 15 percent indicated that they would be implementing similar policies in the near future. Hence, it is safe to assume on the basis of these results that the majority of US hospitals will have smoke-free campuses by the end of 2009," according to Scott C. Williams, PsyD, of The Joint Commission.

The 2008 data shows that not-for-profit hospitals were more likely to have smoke-free campuses than for-profit hospitals. The 2008 data also shows that hospitals in Arkansas, Iowa, Maine, Minnesota, Oklahoma and Wisconsin had among the highest proportion of smoke-free campuses. Hospitals in several tobacco states also had significant proportion of smoke-free campuses.

"In 1992, The Joint Commission implemented a standard which required hospitals to adopt a non-smoking policy throughout all buildings, limiting smoking to separate, ventilated areas. At that time, fewer than 3 percent of hospitals extended this indoor smoking ban to include the entire hospital campus, both indoors and outdoors. Our study shows that around 2004-2005 this began to change dramatically. Now a majority of the nation's hospitals do not allow smoking anywhere on their property," Williams said.

The study examined the current smoking policies and future plans of 1,916 Joint Commission-accredited hospitals to determine the prevalence of smoke-free hospital campus policies and whether such policies had an impact on smoking cessation counseling offered in those hospitals. The study found that not-for-profit hospitals were slightly more likely to offer smoking cessation counseling than for-profit hospitals.

The study also found that federally owned hospitals were less likely to have smoke-free campuses. This, according to the study, was likely due to the influence of federal legislation requiring all Veterans Administration (VA) hospitals to have a suitable and accessible patient indoor smoking area for patients and residents. "Such legislation makes it virtually impossible for VA hospitals to adopt a completely smoke-free campus," Williams said.


The Substance Abuse Policy Research Program ( of the Robert Wood Johnson Foundation funds research into policies related to alcohol, tobacco and illegal drugs.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 30 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. Helping Americans lead healthier lives and get the care they need—the Foundation expects to make a difference in our lifetime. For more information, visit

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