With the epidemic rise in smoking-related illnesses has come the realization that medical institutions should help prevent these diseases, as well as reduce secondhand smoke. Toward this end a comprehensive policy regarding smoking has been implemented in our 489-bed teaching hospital since 1977. Features of this program are policy formation, implementation, and follow-up by a smoking policy committee with hospital-wide representation; no smoking in most areas of the hospital (smoking permitted only in specifically designated areas); no cigarettes sold in the hospital; widespread publicity about health effects of smoking and about the policy through signs, articles, and displays; and clinics for smoking cessation. A follow-up questionnaire given to and answered by 965 of 2,700 hospital staff members 20 months after the start of the smoking policy showed that 93 percent of nonsmokers and 83 percent of smokers approved of the hospital's policy to reduce smoking; 26 percent of the previous smokers queried had quit during that time, and 33 percent of persistent smokers were smoking less. An effective comprehensive hospital-wide policy regarding smoking has reduced smoking by both staff and patients.