Logan Reid
It may seem surprising now, but smoking was once permitted in hospitals. From the late 1800s until the early 1990s, tobacco was a routine part of American hospital life. Doctors, nurses, and patients all smoked, and hospitals sometimes sold cigarettes to patients. Despite health concerns about cigarettes beginning to emerge in the 1930s, smoking was socially acceptable and even glamorous, and it was common for doctors and nurses to smoke while treating patients. By the 1980s, a movement to ban smoking in hospitals had gained momentum, and by 1994, over 96% of US hospitals had implemented smoking bans, improving the health of both patients and hospital workers.
| Characteristics | Values |
|---|---|
| Time period | From the late 1800s until the early 1990s |
| Hospitals | Sold cigarettes to patients |
| Provided ashtrays to patients | |
| Had designated smoking lounges | |
| Doctors smoked while delivering a diagnosis or in the operating room | |
| Nurses smoked at the nurse's station, during report, while organizing med carts, and with their patients | |
| Cigarette ads featured nurses and implied that cigarettes were "recommended by doctors" | |
| Smoking bans | Johns Hopkins Hospital in Baltimore implemented a smoke-free policy in 1990 |
| By 1994, more than 96% of US hospitals complied with the new smoking ban standard | |
| As of August 1, 2019, e-cigarettes were banned in all locations that traditional cigarettes were banned | |
| As of August 1, 2023, smoking cannabis was included in the smoking ban |
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What You'll Learn
Smoking was once common in hospitals
Smoking was once a common sight in hospitals, with doctors, nurses, and patients all lighting up indoors. From the late 1800s until the early 1990s, tobacco was a routine part of American hospital life. Doctors might smoke cigars or pipes while delivering diagnoses or even during operations. Nurses smoked at their stations, during reports, and while organising medication carts. Hospitals sold cigarettes to patients, which were taken into patient rooms on carts, along with other amenities. Some hospitals had designated smoking lounges next to patient rooms.
In the 1930s, health concerns about cigarettes began to receive public attention, with researchers linking cigarette smoke to cancer. However, tobacco companies fought back with advertising campaigns promoting their products as "fresh", "light", "smooth", and "mild". Despite growing awareness of the dangers of smoking, it remained socially acceptable and even glamorous in the following decades. Cigarette ads from the 1950s claimed that cigarettes were "recommended by doctors", and it was common for doctors to hand out cigarettes to patients.
By the 1970s, the message that "smoking is bad for your health" was becoming more widely known, and hospitals began to implement smoking bans. By the late 1980s and early 1990s, smoking was banned in most US hospitals, creating a healthier environment for patients and staff. Today, tobacco smoking is recognised as a leading cause of cancer and respiratory diseases, and smoking is rarely tolerated in hospitals, schools, and businesses.
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Doctors and nurses smoked while working
From the late 1800s until the early 1990s, tobacco was a routine part of American hospital life. Doctors and nurses smoked while working, even in operating rooms and while delivering diagnoses. Hospitals sold cigarettes to patients, which were taken to patient rooms on carts, and ashtrays were provided. Doctors and nurses also appeared in cigarette advertisements during this time, with a 1932 Camel cigarette ad featuring a woman in a nurse's uniform and cap.
In the 1960s and 1970s, the percentage of women and female nurses who smoked grew significantly. This was reflected in medical TV shows like "Emergency" and "M.A.S.H.," which showed doctors and nurses smoking while on duty. In the 1970s, it was common for there to be an ashtray on every patient's nightstand, and hospitals often provided state tobacco for psychiatric patients who couldn't afford their own cigarettes. Despite an official ban on staff smoking in common areas, it was not uncommon for nurses to smoke during their shift.
By the early 1990s, a national movement towards smoke-free hospitals was gaining momentum. In 1993, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) implemented a new standard for smoke-free hospitals, and by 1994, over 96% of US hospitals complied with the ban. Today, smoking is rarely tolerated in hospitals, and new nurses who smoke may find themselves unemployable.
While the rate of smoking among doctors and nurses is lower than in the general population, it still impacts the quality of care they can provide. Doctors who smoke are less likely to advise patients to quit, and nurses who smoke are less likely to arrange smoking cessation follow-ups. As health promoters, smoking can inhibit doctors and nurses from effectively encouraging their patients to quit. Some healthcare providers have recognized this and have chosen to ban smoking on their grounds or refuse to hire smokers.
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Hospitals sold cigarettes to patients
Smoking in hospitals was commonplace in the past, with doctors, nurses, and patients all engaging in the habit. It may seem unthinkable today, but smoking was once considered a glamorous and socially acceptable pastime, and cigarettes were not widely viewed as the harmful, addictive substances we know them to be. From the late 1800s until the early 1990s, tobacco was a routine part of American hospital life. Doctors might smoke cigars or pipes while delivering diagnoses or even during surgeries. Nurses smoked at their stations, during reports, and sometimes with their patients. Hospitals often sold cigarettes to patients, and some even provided free cigarettes to patients who couldn't afford them.
Candy stripers would sell cigarettes to patients in bed, and hospital gift shops and vending machines offered them for purchase. Ashtrays were readily available, often bearing the hospital logo, and smoking lounges could be found next to patient rooms. In state psychiatric hospitals, patients were allowed to smoke in common areas, and staff would provide tobacco to those who couldn't afford it. In some cases, staff would even roll cigarettes for patients who couldn't roll their own. Despite official bans on staff smoking in common areas, these rules were often ignored, with staff smoking during shifts and in break rooms.
However, as early as the 1930s, health concerns about cigarettes began to emerge. Consumers complained about "smoker's cough" and "smoker's hack," and researchers started to link cigarette smoke to cancer. By the 1960s, some hospitals began to act on these concerns, banning the sale and distribution of cigarettes and tobacco products. The Pennsylvania Department of Health, for example, banned sales in state-operated tuberculosis hospitals, and the Veterans Administration prohibited the distribution of cigarettes in its hospitals and domiciliaries.
The tide truly turned in the 1980s and 1990s, with a national movement gaining strength to implement smoke-free policies in hospitals. By 1994, over 96% of US hospitals complied with the new smoking ban, and more than 41% had even stricter policies in place. Today, tobacco smoking is recognized as a leading cause of cancer and respiratory diseases, and hospitals, schools, and businesses have largely become smoke-free environments. New nurses who smoke may even find themselves unemployable due to the shift in cultural attitudes towards smoking.
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Smoking bans began in the 1980s
Smoking was once considered glamorous and socially acceptable. Cigarettes were widely enjoyed by most American adults, and smoking was a routine part of the American hospital landscape from the late 1800s until the early 1990s. Doctors would smoke while delivering diagnoses or even during operations, and nurses would smoke at their stations, during reports, and sometimes with their patients. Hospitals sold cigarettes to patients, and ashtrays were provided in patient rooms. However, as early as the 1930s, health concerns about cigarettes began to receive public attention. Researchers started to link cigarette smoke to cancer, and consumers complained about "smoker's cough". Despite tobacco companies' efforts to promote their products as "fresh", "light", and "mild", the tide was turning.
In the 1970s and 1980s, public awareness of the health risks of smoking and secondhand smoke grew, and people began calling for restrictions. The confined space of aeroplanes made the harmful effects of smoke impossible to escape, and governments started to act. The movement to ban smoking on planes gained momentum in the late 1980s, and several reports in the 1980s concluded that involuntary smoking had adverse effects. In 1988, smoking was banned on domestic flights under two hours, and this was extended in 1990 to flights of up to six hours.
In the US, the movement towards smoking bans began in 1975 with Minnesota's Clean Indoor Air Act, which established "no-smoking" sections in restaurants. However, it wasn't until the late 1980s and early 1990s that many other states followed suit. By 1994, more than 96% of US hospitals complied with the new smoking ban standard, and more than 41% had enacted even stricter policies. Johns Hopkins Hospital in Baltimore was at the forefront of this movement, with a stringent smoke-free policy for staff in place by 1990. The hospital's employee handbook stated that failure to comply with the ban on smoking in a non-designated area was a "critical violation" of the employee code of conduct.
The implementation of smoking bans has had a marked effect on the smoking behaviour and health of hospital workers. Bans have also been shown to reduce the prevalence of smoking and the demand for tobacco products. While smoking bans have endured some criticism from those who believe they infringe on the rights of smokers, they are typically supported by the public. A Gallup Poll from July 2019 showed that 62% of Americans were in favour of banning smoking in all public places.
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Smoking is now banned in hospitals
From the late 1800s until the early 1990s, tobacco was a routine part of American hospital life. Doctors might smoke cigars or pipes while delivering diagnoses or even during operations. Nurses smoked at their stations, in common areas, and sometimes with their patients. Hospitals sold cigarettes to patients, and ashtrays were provided on patient nightstands. It was not uncommon for doctors to recommend smoking, and cigarette advertisements would even claim that their products were "recommended by doctors."
However, as early as the 1930s, health concerns about cigarettes began to receive public attention. Researchers linked cigarette smoke to cancer, and consumers complained about "smoker's cough." Despite tobacco companies' efforts to downplay these concerns, the tide began to turn against smoking. By the 1970s, the Surgeon General declared that "smoking is bad for your health."
The movement to ban smoking in hospitals gained strength in the 1980s and accelerated in the early 1990s. By 1994, more than 96% of US hospitals had implemented smoke-free policies, and more than 41% had enacted even stricter rules. Today, smoking is banned not just in hospitals but also in a growing number of public places and workplaces across the United States. This includes public transportation, enclosed public spaces, bars, restaurants, and workplaces.
The ban on smoking in hospitals has had a positive impact on the health of both patients and hospital staff, creating a healthier environment for all.
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Frequently asked questions
Yes, smoking was allowed in hospitals in the past. In the 1960s and even into the 1970s and 1980s, smoking was permitted nearly everywhere, including in hospitals.
Yes, patients smoked in hospitals. Hospitals sometimes sold cigarettes to patients, which were taken into patient rooms on carts, along with other items such as chewing gum, toiletries, and books.
Yes, doctors and nurses smoked in hospitals. It was considered \"normal\" to see physicians making rounds with an ashtray and a cigarette. A study at University Hospital in 1982 found that nurses who smoked found their job more stressful.
