When he was surgeon general, C. Everett Koop challenged the United States to adopt a smoke-free society by the year 2000.1 The two articles on smoking in hospitals that appear in this issue of JAMA demonstrate that the US health care industry has almost achieved this goal.2,3 However, both surveys report that smoking in psychiatry and chemical dependency programs remains a problem. Because smoking kills these patients, too,4 and smoking can be treated in chemical dependency programs without compromising abstinence rates from other addictive substances,5 smoke-free must become the industry standard for all treatment units.
Should it surprise us that three decades have elapsed since the first surgeon general's report on smoking and health,6 two decades have elapsed since the concept of the smoke-free hospital was advocated in print,7 and it's been a decade since the surgeon general concluded that environmental tobacco smoke kills?
Kottke TE. Smoke-Free 2000A Step Closer. JAMA. 1995;274(6):503-504. doi:10.1001/jama.1995.03530060077039