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January 1, 1992

The Department of Veterans Affairs Smoke-Free Policy

Author Affiliations

From the Department of Medicine, Veterans Affairs Medical Center, University of Minnesota, Minneapolis (Dr Joseph), and the Corporate Health Policies Group, Inc, Washington, DC (Ms O'Neil). At the time of this study Ms O'Neil was with the Veterans Health Services and Research Administration Smoke-Free Initiative, Department of Veterans Affairs, Washington, DC.

JAMA. 1992;267(1):87-90. doi:10.1001/jama.1992.03480010095031

THE Department of Veterans Affairs (VA), the largest health care provider in the United States, implemented an agency policy on January 7, 1991, requiring all 172 acute-care hospitals to be completely smoke-free.1-3 The VA initiative followed directives by other government agencies for smoke-free environments, such as the US Army4 and the Indian Health Service.5 Smoke-free hospitals have been endorsed by the American Medical Association, the American College of Physicians, and the US Preventive Services Task Force, as well as other organizations.6

This policy was written in a national climate that is increasingly intolerant of environmental tobacco smoke, although hospitals commonly continue to allow smoking in designated areas. Several medical centers have become completely smoke-free,7-13 and the states of Minnesota and Maine have passed legislation requiring health care institutions to be smoke-free. Because of the national trend in legislation of public smoking (including the Joint Commission