It is paradoxical for hospitals, institutions that exist to promote health and treat disease, to permit smoking—the single, most preventable cause of illness and death in the United States today. The adoption of a nonsmoking policy by hospitals can provide an environment for and model the behaviors that promote health and prevent disease. By continuing to treat illness, while at the same time allowing smoking, hospitals perpetuate the schism between prevention and treatment that exists in medicine today. Nonsmoking policies can be implemented with little disruption to staff and patients when planned in a thoughtful manner, as Knapp and Kottke1 describe in their article in this issue of the Archives.
Hospitals, which are large worksites, are not alone in adopting nonsmoking policies. As the evidence of health risks associated with passive smoking has accumulated, an increasing number of worksites have adopted policies that restrict smoking.2 As reported in