We note with interest that the work of Shipley and Allcock published recently in this journal. Of particular, interest is their description of staff unwillingness to challenge smokers who are smoking on smoke-free hospital sites. More than 50% would not challenge staff or visitors or patients smoking on site. We encountered similar enforcement issues when Hunter New England Health, an area health service of NSW Australia went totally smoke-free across all of its 41 inpatient sites in October 2006. Twenty months after going smoke-free, we conducted interviews with all 139 nurse managers across the inpatient facilities and found that, only one-third reported that most of their staff would approach tobacco users and ask them to stop smoking on hospital grounds.