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The NHS as an agent of change: creating a smoke-free environment in hospital.

In 1985 a Health Circular (HC(85)22)1 asked all District Health Authorities (DHAs) to draw up written policies which would establish non-smoking as normal practice on health service premises and for health service staff. Two years later, a survey of all 191 English Health Authorities assessed progress. Results of the survey indicate a high degree of compliance with the primary goal of each DHA. However, few DHAs gave a policy which contained explicit guidelines on implementation and monitoring procedures. This might have had considerable impact on commitment to smoke-free provision in hospitals.