Smoking is related to a wide range of intra- and post-operative complications. In relation to the idea of health promoting hospitals, we investigated how Danish departments of anaesthesia dealt with tobacco smoking and the surgical patient. We sent a questionnaire to 44 Danish departments of anaesthesia with seven questions about practical management of tobacco related problems in anaesthetic practice, the information of patients and the state of preventive initiatives. At about half of the departments patients are not asked about their smoking habits and at only seven departments is the patient given oral information about their increased intra- and postoperative risks. Half of the departments advocate smoking abstinence in the six fasting hours. Two departments offer assistance to preoperative smoking cessation within a scientific preventive project. In conclusion, the idea of prevention of intra- and postoperative complications by means of preoperative smoking cessation has not gained interest at Danish departments of anaesthesia so far.