IN 1992 Congress passed the Veterans Health Care Act (Pub L No. 102-585).1 This legislation requires Department of Veterans Affairs (VA) hospitals to establish "suitable" indoor or outdoor smoking areas that have "appropriate heating and air conditioning." This law is a major setback to progress accomplished by the nationwide VA hospital smoke-free policy implemented in 1991.2-4 The law puts VA hospitals out of step with public and private hospitals and supersedes the Joint Commission on Accreditation of Healthcare Organizations' smoke-free hospital accreditation standard,5 and it has forced the VA to spend millions of dollars of the medical care budget on construction of smoking areas.
A brief history only partially explains this turn of events. The image of a smoking veteran is a familiar one. The US government distributed millions of cartons of free cigarettes to World War II service personnel. Staging areas in the European theater of
Joseph AM. Is Congress Blowing Smoke at the VA?. JAMA. 1994;272(15):1215-1216. doi:10.1001/jama.1994.03520150083042