When 115 health-care workers participated in a study that monitored their serological responses to hepatitis B vaccine at regular intervals, it was found that smoking significantly affected their antibody titre responses adversely. The study group was randomly allocated into two comparable groups that received hepatitis B vaccine either in a rapid schedule (vaccination at 0, 1, 2 and 12 months) or a standard schedule-most commonly used worldwide-(vaccination at 0, 1, and 6 months). A significantly higher proportion of smokers, in both schedules, failed to seroconvert and to achieve higher antibody levels at month 3 (p = 0.01) and at month 13 (p = 0.0003). At month 7 a similar pattern was noted in smokers following the standard vaccination schedule (p < or = 0.05), but not in those following the rapid schedule.