Establishing nonsmoking policies in hospitals--even on acute psychiatric units--requires patience, planning, and a bit of nerve. The benefits of such a move, however, can be significant for patients and staff. When Vancouver General Hospital implemented a complete indoor nonsmoking policy on its psychiatric assessment and inpatient psychiatry units, workplace conditions noticeably improved, and some long-standing beliefs about psychiatric patients were disproved. Several conditions provided the impetus to change to a nonsmoking policy. With a few exceptions (palliative care, the burn unit) the indoor areas were nonsmoking; nevertheless, the hospital environmental committee considered a site-wide (indoor and outdoor) ban on smoking. One reason was that the community funding that had provided psychiatric patients with cigarettes would soon be cut off. Another reason was that all psychiatry units were anticipating moving into the new hospital tower--a facility slated to be smoke-free--on its completion.