Eight Hospital Ashtrays

An illustrated history of hospitals and smoking

For nearly three decades following the publication of the landmark Surgeon General’s report on smoking and health in 1964, hospital administrators, medical staffs, and the American Hospital Association all dragged their feet in prohibiting smoking in health care facilities. Even after Congress banned smoking on airlines in 1988 and after many major cities passed clean indoor air laws restricting smoking in public places, few hospitals discouraged patients, visitors, medical personnel, and other employees from smoking. In 1991 The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) mandated that hospitals be smoke-free by December 31, 1993…with exceptions for patients whose physicians wrote a note in the chart permitting it. This exhibition presents examples of artifacts and images, selected from the Center’s collection, from a hopefully bygone era.

Click on the Ashtrays below for a closer look. Scroll right to see more

Mount Sinai Medical Center Ashtray (alt)

Hospital Artifact - Riley County Hospital Ashtray (Top)

Hospital Artifact - Buffalo General Hospital

Blue Cross Plan Ashtray
“The Best Way to Pay Hospital and Doctor Bills”
Baton Rouge, Louisiana
Circa 1960

MD Anderson Hospital and Tumor Institute Ashtray
Houston, Texas
Circa 1955-1988

Mount Sinai Medical Center Ashtray
Unknown location
Circa 1960

Johns Hopkins Hospital Ashtray
Baltimore, Maryland
Circa 1950

Riley County Hospital Ashtray
Kansas
Circa 1945

Druid City Hospital Ashtray
Tuscaloosa, Alabama
Circa 1960

Buffalo General Hospital Ashtray
Buffalo, New York
Circa 1950’s

The Doctors Hospital
Seattle, Washington
Circa 1950’s

Matchbook, Greater Baltimore Medical Center
Circa 1960

“Australia Hospital Day for Charity”

Fundraising button for Australian hospitals showing nurse lighting a bedridden patient’s cigarette
Circa 1914

Mayo Clinic cigarette case
Circa 1960

“At Babies’ Hospital, Brockley”

Cigarette trading card Number 35 in the 50-card series “Our King and Queen” showing Queen Mary at the opening of the Albany Deptford Babies’ Hospital in Brockley in 1933.

W.D. & H.O. Wills, subsidiary of of Imperial Tobacco
1937

“The King and the Wounded: His Majesty’s Representative Visits a Glasgow Hospital, with Gifts of Cigarettes”

Photograph in The Illustrated War News
February 23, 1916

Photograph of U.S. Army nurses smoking

Acquired by CSTS from Underwood Archives
Circa 1945

“Patients, please smoke only when there is an ash tray within easy reach.”

The photographs in this gallery are from the late-1960s and depict cigarette displays in a hospital gift shop, a patient smoking, a physician smoking on rounds, and a Candy Striper on a hospital ward selling snacks and cigarettes to patients.

Courtesy, UAB Archives (University of Alabama at Buirmingham). Tim Pennycuff, UAB Archivist, discovered these photographs.

“Every week of the year the Camel people send cigarettes to servicemen’s and veterans’ hospitals…”

Television commercial by RJ Reynolds Tobacco Company for Camel cigarettes
Circa 1950

“Know your Doctor“

R.J. Reynolds Tobacco Company promotional coffee table book of paintings saluting physicians, sent to doctors for display in their office waiting rooms. The images were the same ones used in Camel cigarette advertisements with the theme, “More Doctors Smoke Camels Than Any Other Cigarette,” which ran from 1946 to the early 1950s in LIFE, TIME, and other popular magazines. The “Dear Doctor” letter below accompanied the book.
Circa 1950

“Dear Doctor:”

Cover letter accompanying promotional coffee table book published by R. J. Reynolds Tobacco Company for physicians’ waiting rooms, featuring the images from the advertising campaign for camel cigarettes, “More Doctors Smoke Camels Than Any Other Cigarette”
Circa 1950

“This series, sponsored by CAMEL Cigarettes, presented in graphic and dramatic form the story of the doctor — his student days, is internship, his practice, his family and home — as so few of his patients know it.

“Each successive advertisement brought mounting requests for reprints and copies of the illustrations for framing. These requests came from individual physicians, medical students, medical schools and societies, hospitals, wives and families of physicians in sch numbers that our supply was soon exhausted…”

“The Light that Never Fails! ‘Emergency Case!’ While the city sleeps, lights blaze in a hospital ward–they mean ‘Doctors at Work!'”

Advertisement for RJ Reynolds Tobacco Company’s Camel cigarettes, one of the only cigarette ads ever to feature a hospital.
LIFE Magazine
1946

“Truly, this is America…the Doctors Meet”

…and smoke in the hospital doctors lounge in this advertisement by CIBA Pharmaceutical Products
1946

“Please be careful!…Please smoke only when there is an ash tray within easy reach.”

Hospital bedside promotional card distributed by Philip Morris featuring its spokesman, New York City bellhop Little Johnny (Roventini)
Circa 1945

“How to make the Doctor say ‘Ah!'”

KOOL cigarettes promotional card, two sides
Brown and Williamson Tobacco Company

1940s

Photograph of Brigitte Nahmias, MD and Alan Blum, MD in cigarette vending machine alcove at Grady Memorial Hospital, Atlanta, Georgia. Dr. Nahmias gave the only lecture on smoking in the four-year medical school curriculum at Emory University School of Medicine, where Dr. Blum obtained his medical degree in 1975.
1980

Nurse in front of cigarette vending machine at Grady Memorial Hospital
1980

“Smoke Gets in Your Lives”

Article by Brigitte B. Nahmias, M.D. Director Albert Steiner Memorial Emphysema Clinic,
St. Joseph’s Infirmary, Atlanta
ANLAGE (student newspaper of Emory University School of Medicine)
January 1973

“In the regional Emphysema Clinic we see hundreds of patients each year who are referred for diagnostic studies or therapeutic guidance because of chronic pulmonary disease. Thirty years ago such a clinic would have been unnecessary. Furthermore, the Georgia Regional Medical Program has asked us to aid other health facilities in providing similar services. Why? Read more…

Matchbook from The Doctors Club, Texas Medical Center, Houston, Texas
Circa 1990

“Hospitals Wage a Losing Battle to Curtail Smoking”

Front-page article
The New York Times
February 28, 1977

“A doctor holding an unlit cigarette in a fifth-floor corridor of Southern Baptist Hospital in New Orleans was asked by a visitor if smoking was permitted in the corridors. The doctor cupped his hand over the cigarette and said, ‘I’m the wrong one to ask.’

“Smoking in the nation’s hospitals institutions that treat patients with lung cancer. emphysema, and heart ailments, appears to be inevitable among addicted staff members, patients and visitors.

“Michael Reese Hospital in Chicago once had its cigarette vending machines removed in an attempt to discourage smoking, but replaced them after finding that bedridden patients were paying up to 50 cents for a cigarette on a black market run by some of the staff members.

“Officials at the University of Virginia Hospital in Charlottesville, where seven cigarette machines produce $25,000 a year in sales, decided eight years ago against banning sales because of the potential financial loss.

“The medical staff at Mt. Sinai Hospital in Hartford recently voted to outlaw smoking at all staff meetings, but also provided a five-minute break for smokers. The Methodist Hospital in Houston, Harper Hospital in Detroit and Arlington Hospital in Virginia have offered matchbook covers with the names of the hospital printed on them.

“Interviews with administrators, doctors and other personnel—many of them smokers—at more than 30 of the nation’s hospitals indicate that pressure for tighter restrictions is being exerted, with varying degrees of success. Doctors who have kicked the habit are considered among the leading proponents of change.

“New York City’s Sloan‐Kettering Institute for Cancer Research for example, has banned smoking on its entire 15th floor.

“We have completely cut out smoking in the halls, lounges, offices and wards on that floor,” said Gerald Delaney, spokesman, “but although patients will not smoke on the 15th floor, they sometimes go to another floor where smoking is allowed, and do it there.”

“A spot check of five hospitals in the New York metropolitan area disclosed disparate policies on cigarette sales. Sloan‐Kettering and the Presbyterian Hospital in the City of New York have discontinued such sales, while Roosevelt, Bellevue and Nassau Hospital in Mineola permit them…”

Photograph of Alan Blum, M.D. and a patient at Jackson Memorial Hospital, Miami, following the introduction of a no-smoking policy at entrances to clinics.
1978

“Miami doctors’ group launches paid satirical advertising campaign to mock smoking and cigarette makers” (01:22)

Video of news story by Bob Jackson
WTVJ-TV Channel 4 (CBS affiliate), Miami, Florida
September 1977

“Hospitals and smoking don’t mix”

One of the first paid bus bench anti-smoking advertisements by DOC (Doctors Ought to Care)
placed in front of Jackson Memorial Hospital, Miami
September 1977

“Dear Jackson:
What caused that $60,000 fire at Westchester Hospital?
One cigarette. Love, DOC“

Photograph by Alan Blum, MD of bus bench in front of Jackson Memorial Hospital, Miami, with paid advertisement by DOC (Doctors Ought to Care)
1978

Jonathan Bean is a Research Fellow at the Independent Institute (https://www.independent.org/) and a Professor of History at Southern Illinois University. Professor Bean is the author of Race and Liberty in America: The Essential Reader (2009), Beyond the Broker State: Federal Policies Toward Small Business, 1936-1961 (1996); Big Government and Affirmative Action: The Scandalous History of the Small Business Administration (2001); and Opposing Viewpoints in U.S. History (2018). He received the Henry Adams Prize for Best Book of the Year from the Society for History in the Federal Government and was named Outstanding Teacher of the Year at Southern Illinois University in 2005. In 2017, Southern Illinois University awarded Professor Bean the Graduate Faculty Mentor Award of Excellence.

“Doctors Ought to Care: A History of Smoke-Filled Hospital Rooms, 1950-1993” (37 pages)
Report by Jonathan Bean, PhD
Professor of History, Southern Illinois University

2010

“The … article analyzes what hospitals knew, and did, about the health hazards of smoking, with a focus on the national level and a case study of Missouri, where the link between smoking and lung cancer first burst onto the American scene, in 1950, with a JAMA [Journal of the American Medical Association] article published by St. Louis doctors [Medical student Ernst L. Wynder and thoracic surgeon Evarts A. Graham of Washington University School of Medicine, “Tobacco smoking as a possible etiologic factor in bronchiogenic carcinoma: a study of six hundred and eighty-four proved cases” https://www.scielosp.org/pdf/bwho/v83n2/v83n2a15.pdf ]. Not surprisingly, the medical profession was the segment of society best educated on smoking and health issues. Likewise, hospital administrators were continually concerned with factors contributing to rising health costs. The hospital section of the National Conference on Smoking and Health (1981) noted that ‘as healing institutions, hospitals are particularly aware of the scientific evidence indicating the health and safety hazards and related economic costs of smoking …’ Yet, despite their acute awareness of the health hazards and costs of smoking, hospitals established weak smoking policies, sold cigarettes to patients and permitted smoking in hospital rooms decades after the Surgeon General warned the public not to smoke. Despite steady criticism from within the profession and from without, most hospitals did little or nothing to curb smoking until their accrediting body forced them to ban it in 1993….

“Despite the awareness of health hazards and economic costs, the official policies of leading hospital associations toward smoking were virtually non-existent (1964-1974) to weak (1975-1993)… [T]he American Hospital Association Board of Directors endorsed the Surgeon General’s report of 1964 but took no further action, leaving the matter to be decided at the local level. A Hospitals [trade journal] survey of local and state hospital associations (1964) found that they were ‘acutely aware of the report’s implications’; but member hospitals saw no need to take action. In 1974, the AHA signed the ‘Bill of Rights for Nonsmokers,’ developed by the National Interagency Council on Smoking on Health, but…nonsmokers had few rights in most hospitals. Five years later, the AHA issued a Policy and Statement on the Hospital’s Responsibility for Health Promotion and distributed a smoking cessation guidebook to 2,000 hospitals; little progress, however, was made: ten years later, only 37 percent of hospitals offered quit-smoking services…”

Letter from Alan Blum, MD to Fred J. Cowell, president Jackson Memorial Hospital, Miami, urging that smoking be banned in most areas of the hospital in the interest of public health and safety. (5 pages)
January 23, 1978

“The present hospital policy on smoking (updated September 14, 1977) is worthless. It essentially permits smoking except where there is oxygen, and it is simply not being enforced. Would that certain hospital personnel were as diligent in enforcing rules which uphold fire regulations and encourage good health practices as they are about chastising a group of physicians who undertake to document violations of hospital policy. Please see the enclosed photographs, all of which were unposed. Enclosed, too, is a transcript of a statement by one of Dr. Tate’s patients, a woman who has had to be hospitalized on several occasions because of the overwhelming amount of cigarette smoke in the outpatient clinic…Read more.

“Smoking Guidelines for Hospitals”

Questions and Answers feature by Alan Blum, MD
Journal of the American Medical Association
July 11, 1980

Q: “… Are there specific guidelines for a rational smoking policy for hospitals? For example, should smoking be allowed in patients’ rooms?…”

A.: “…It is essential to remember that in the hospital
setting, smoking is as much a fire problem as a health
problem. According to the Joint Commission on Accreditation of Hospitals (JCAH) smoking is responsible for
approximately 60% of the estimated 1,500 annual reported
hospital fires. (The next leading cause, faulty electrical
wiring, is responsible for 20% .) Moreover, fires present a
greater danger in health care facilities than in other
environments because of the number of incapacitated
patients who are unable to escape.

“Although the JCAH suggests that all hospitals adopt
and enforce a strong set of. smoking regulations, their
publications on the subject (eg, 1980 Accreditation Manual
for Hospitals, p 45) are almost entirely concerned with
containing rather than preventing fires. Only seven
specific recommendations are made regarding smoking,
such as the following: ‘Patients who are confined to bed
should be discouraged from smoking,’ and ‘Ashtrays
shall be noncombustible:'”

“Problem Clinic: Hospitals and Smoking” (3 pages)

Article by Alan Blum, MD
Employee Health & Fitness
(with letter of June 21, 1980 to Dr. Blum from Katie Baer, Editor)
August 1980

“I was delighted to receive your column on smoking in hospitals. You pulled no punches and yet, your perspective included an appreciation for political realities in the hospital. Many good things get done in the name of JCAH compliance!”

“Hospitals challenged to restrict smoking” (3 pages)

Article by Joyce Riffer
HOSPITALS
March 16, 1982

“Hospitals across the country…recognize their responsibility as health care institutions to discourage smoking, yet problems with enforcing
smoking policies, concern for patients’ rights, and attitudes and smoking behavior of the hospital staff are major obstacles to doing more to control smoking.

“Faced with the staggering cost of treating smoking-related diseases and the rising number of deaths each year from smoking, hospitals are being asked to get around those obstacles and play a more exemplary role in discouragement efforts. Medical
costs from smoking rose to $27 billion last year, according to the Surgeon General’s office, and claimed 350,000 lives from coronary heart disease, respiratory disease, and cancers of the lung, larynx, oral cavity, and esophagus. Smoking is also linked with cancers of the pancreas, bladder, and kidneys…

“A total ban on smoking would not be feasible, most hospital spokesmen said; because of the fire risks from people who would ignore the rules. ‘People would be sneaking smokes under the covers,’ according to the safety director of a Chicago hospital. A risk manager at a Philadelphia hospital said ‘outlawing cigarettes will only cause more problems.’

“One hospital that has placed a total ban on smoking is Elmcrest Psychiatric Institute, Portland, CT. ‘As a health care provider, we didn’t feel we could run an institution where we’d allow patients to kill themselves with cigarettes,’ according to George Thiffault, director of public information. The transition to a no-smoking environment in February 1980 was not an easy one, Thiffault explained. Some employees quit because of the policy. Others stayed and participated in stop-smoking groups sponsored by the hospital for patients and employees. ‘There was a tremendous amount of grousing from both staff and patients,’ according to Thiffault, but he said the program has been working…

“‘I’m shocked and embarrassed that hospitals have lagged behind on the issue of smoking,’ said Alan Blum, M.D., of the Chicago-based Doctors Ought to Care (DOC). An organization with 1,000 members and 40 chapters nationwide, DOC aims to educate the public about good health habits and to dispel the myths used in advertising unhealthy products. ‘It is offensive to the nature of what we do for a living to permit smoking in hospitals,’ Blum said, contending that hospitals do not have more stringent smoking policies because it is not in their self-interest to be more restrictive. ‘There is no profit incentive for the hospital to prohibit smoking.'”

Letter from Alan Blum, MD, editor of the New York State Journal of Medicine, inviting Judy Shaw, an executive of the American Hospital Association, to contribute an essay on smoking and hospitals for a theme issue in July 1985 on the world tobacco pandemic (2 pages)

November 21, 1984

“I believe I have heard every rationalization in the book from hospital administrators concerning their unwillingness to create a smokefree hospital setting. In 1976, one administrator responded to my proposal for a smoking room for patients and personnel alike on every floor (and nowhere else in the building) by exclaiming, ‘But doctor, what about the patients in traction?’ Auxiliary gift-shop proprietors have complained that ending cigarette sales would curtail income. Administrators have claimed there would be a black market run by orderlies. Most administrators artfully pass the buck by claiming that it is the medical staff who either won’t obey rules on smoking or who simply don’t care…

“A couple of good news items in the past year concern hospitals in Arizona and Washington State that have gone smoke-free. I also gather that Group Health in Seattle no longer hires employees who smoke. But overall it’s my impression that the American Hospital Association has few if any policies on smoking for its members. The rise of for profit hospital chains (such as Humana headquartered in the tobacco state of Kentucky) leads me to wonder whether the all-out quest for profit will leave the smoking issue even lower down on the list of priorities, as hospitals claim that they would not wish to offend anyone who wishes to smoke (for fear that the patients will go down the street to another hospital).”

“Tobacco related diseases among native Americans”

Letter by Leland J. Fairbanks, MD
New York State Journal of Medicine
July 1985

“…Despite the traditional use of tobacco during special ceremonies among many of the more than 250 American Indian tribal groups, there have been remarkably few habituated smokers.

“An example of the type of ceremonial use of tobacco by the largest of the American Indian tribes (as told to me by a former director of the Navajo Medicine Man’s Association) is as follows: In a “smoking ceremony” to aid an ill person, the medicine man would place tobacco and corn husks in a pipe. The patient was then instructed to inhale deeply until it caused vomiting, and also often diarrhea.The aim was to thus clean out the body from both ends. The toxicity of tobacco was thus turned into constructive use as a purgative.

“In the mid 1970s, however, the increased daily cigarette smoking by American Indians (especially in Alaska, Oklahoma, and the Dakotas) was leading to an increased incidence of lung cancer, chronic obstructive pulmonary disease, and coronary artery disease. Great attention has since been directed by physicians of the Indian Health Service to vigorous antismoking education…

“…A positive first step was recently taken by the Keams Canyon (Arizona) USPHS Indian Hospital on the Hopi Indian Reservation. With full staff and community support, the hospital is now 100% free of tobacco smoke.”

Curator’s note: Dr. Fairbanks (1931-2025) was a longtime leader in tobacco control and President Emeritus of Arizonans Concerned About Smoking

“…little more than Koop grabbing for headlines”

Memorandum to Sam Chilcote, president, The Tobacco Institute, from Susan Stuntz, vice president
for Public Relations, The Tobacco Institute
June 17, 1988
Identified in the Tobacco Industry Documents Library
https://www.industrydocuments.ucsf.edu/tobacco/docs/#id=qqnn0040

“To follow up on your request that we take a close look at our options in light of the Surgeon General’s recent request of hospitals that they ban smoking, or risk losing federal Medicare reimbursement, we have asked Federal Relations to help us obtain a copy of the Koop/Roper letter referenced in the attached news article. Once we have the letter, we will forward it to counsel, for an assessment of the legality of the Koop/Roper proposal.

“In the meantime, however, we have spoken with contacts at the American Hospital Association, who tell us that AHA has taken no formal position on the proposal, believing it to be little more than Koop grabbing for headlines. They are in the process of determining whether HHS has the statutory authority to deny Medicare funding to hospitals that fail to respond to Koop’s request.

“AHA tells us that it can be expected to oppose in principle the Koop/Roper proposal, as it could set a precedent to deny reimbursement to hospitals that perform abortions, or that fail to meet other standards set by social regulators.”

“Hospital smoking policies” (3 pages)

Memorandum from Marty Gleason, director of Issues Management, The Tobacco
Institute to Peter G. Sparber, Sparber and Associates public relations firm (and until
1988 vice-president, Public Relations, The Tobacco Institute)
June 27, 1989
Identified in the Tobacco Industry Documents Library
https://www.industrydocuments.ucsf.edu/tobacco/docs/#id=jpny0032

“With the exception of New Jersey hospitals, the overwhelming majority of public and private hospitals nationwide permit smoking in at least some part of their facilities.

“According to a 1987 American Hospital Association survey of 5,600 institutions, about 16 per cent maintain ‘smoke free’ environments. The term ‘smoke free’ means that smoking is disallowed by patients, staff and guests but may be allowed – particularly in psychiatric or substance abuse wards –- with the written permission of the attending or responsible physician.

“No other smoking-related question was asked in the 1987 survey. However, hospitals typically restrict smoking where contamination and safety may be a problem, e.g. near oxygen, in operating rooms, food preparation areas, etc. My contact at AHA also noted that few hospitals allow cigarette sales in gift shops or through vending machines…

“AHA has a ‘smoke free’ hospitals kit entitled ‘Hospitals and Smoking – a bad match.’ It is available for $35…[Curator’s note: This kit is identified in the Tobacco Industry Documents Library:
https://www.industrydocuments.ucsf.edu/tobacco/docs/#id=lrdc0090]

“New Jersey is the one state active on the issue, according to AHA. Working on a $30,000 Department of Health grant, a single staff member at New Jersey Hospital Association is charged with encouraging all 119 institutions in that state to declare ‘smoke fee’ policies by January 1992.

“To date, she reports that 13 are ‘smoke free’ and another 62 will be ‘smoke free’ by May 1, 1990…

“Two other states are somewhat less active, according to AНА They are Minnesota (no surprise) and Pennsylvania. However, I could find little evidence of anything close to New Jersey’s initiative.”

“…discouraging the American Hospital Association from…encouraging smoking bans in hospitals”

Memorandum from Susan Stuntz, vice president, Public Relations, The Tobacco Institute, to Sam
Chilcote, president, The Tobacco Institute
May 17, 1991
Identified in the Tobacco Industry Documents Library
https://www.industrydocuments.ucsf.edu/tobacco/docs/#id=mshg0051

“Attached for your review are copies of programs for two components of our expanded public smoking/workplace effort. The first addresses efforts to discourage health insurers from discriminating against smokers and relies largely on allies and outside consultants to accomplish our goals.

“…A third program aimed at discouraging the American Hospital Association from launching a nationwide public relations campaign encouraging smoking bans in hospitals is undergoing legal review; we hope to have it ready for your review and for presentation as well on Wednesday.”.

“Hospital Strategy Plan” (5 pages)

Memorandum from Martha Rinker, issues manager, The Tobacco Institute, to Susan Stuntz, vice-
president, Public Relations, The Tobacco Institute
May 21, 1991
Identified in the Tobacco Industry Documents Library
https://www.industrydocuments.ucsf.edu/tobacco/docs/#id=nskh0027

“This proposal is in response to the Joint Commission on the Accreditation of Healthcare Organizations (JCAH) requirement that hospitals enforce smoking bans for maintenance of their accreditation. Read more…

“Smoking in psychiatric hospitals: A historical view of a hot topic”

Article by Jeffrey L. Geller and Neil Kaye
Hospital and Community Psychiatry
Volume 412, number 12, pages 1349-1350
1990

“Dr. [Samuael B.] Woodward’s* concerns about the effects of tobacco led him to attempt a ban on its use at Worcester State Hospital in 1833-34. His comments in the 1834 paper sound remarkably modern in their intent and outcome. ‘Some interesting cases of the influence of tobacco upon the system have occurred in the hospital which I superintended during the last summer. Well knowing that tobacco was liable to be very improperly used by the insane, an early effort was made to exclude it from the hospital. In order to effect this, the attendants on the patients were requested to relinquish the habit, and a regulation was adopted, requiring that the use of it be prohibited wholly in the Institution. To this regulation a large proportion submitted with a most commendable spirit, others were very unhappy, suffered much, were irritable, and could neither eat nor sleep; most of these soon became reconciled, got over the horror, and appeared decidedly better; a few, however, will take every opportunity to obtain it of strangers and visitors, and the regulation is not adhered to with as much strictness as would be desirable.’

“Dr. Woodward’s account of his efforts to fashion a tobacco-free psychiatric hospital may well be the earliest documented attempt in America to achieve this end (JC Burnham, personal communication, March 1, 1990). Knowing about it has helped us sustain our efforts to accomplish the same goal at Worcester State Hospital in 1990.”

*Curator’s note: Samuel B. Woodward, M.D. {1787-1850) was a founding member of the American Psychiatric Association and its first president. He was the first superintendent of the Worcester State Hospital in Massachusetts for 1832 to 1846.

“Hospital efforts in smoking control: remaining barriers and challenges”

Article by Adam O. Goldstein, Windsor Westbrook, R. Edward Howell, and Paul M. Fischer
The Journal of Family Practice
Volume 34, Number 6, pages 729-734
1992

“…our study points out an important caveat: establishing smoke-free hospitals cannot be viewed as an end in itself, but as part of the evolving process of creating comprehensive hospital tobacco-control programs.

“Our research shows that many hospitals will continue to face difficult challenges for many months after implementing smoking bans. First is the issue of noncompliance with the policy. In some hospitals, almost one in five employees reported seeing the smoke-free policy violated more than six times in 1 month. In such cases, specific areas, eg, hospital bathrooms, have likely replaced smoking lounges as alternatives for smokers attempting to continue smoking in the hospital. To help avoid undermining the smoke-free policy, hospitals should direct special attention to high-risk areas and consistently enforce the policy. If a consistent system of monitoring, feedback, and reprimand is maintained, violations should become less frequent. It is important that hospital administrators deal with known violations just as they would any other violation o f hospital policies, thus reinforcing and focusing attention on the policy itself, not on the individual…”

“Join hospitals across the nation going smoke-free for good.”
Reverse side: “Your hospital may be overlooking a vital sign.”

Poster created by Smoke Free 2000, Minnesota Coalition for a Smoke-Free Society 2000 [Organization existed from 1984 to 2007]
Circa 1998

Eight Hospital Ashtrays

Curated by Alan Blum, MD

Professor and Endowed Chair in Family Medicine
Director, Center for the Study of Tobacco and Society
College of Community Health Sciences
The University of Alabama School of Medicine, Tuscaloosa

Designed by Kevin Bailey, MA

Collections Manager and Digital Archivist (2018-2022)
Center for the Study of Tobacco and Society
College of Community Health Sciences
The University of Alabama School of Medicine, Tuscaloosa

Updated Design (2025) by Bryce Callahan

Undergraduate student majoring in computer engineering
The University of Alabama

“SMOKERS! Will You Help the London Hospitals and Charities at No Expense to Yourselves?”

Advertisement by J. Samuda announcing his donation of £20,000 to London hospitals and charities to celebrate his discovery of producing the world’s finest tobacco, “free from any trace of arsenic,” for his company’s cigarettes and cigars
The Illustrated London News

November 28, 1903