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October 19, 1994

Is Congress Blowing Smoke at the VA?

Author Affiliations

From the Section of General Internal Medicine, Veterans Affairs Medical Center, Minneapolis, Minn.

JAMA. 1994;272(15):1215-1216. doi:10.1001/jama.1994.03520150083042

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

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