Most hospitals still have smoking rooms

The Health Development Agency said the complete ban was a "gold standard" which NHS trusts should aim for.

HDA officials issued the guidance after the government's Public Health White Paper promised the health service would become smoke-free by the end of 2006.

NHS chief executive Sir Nigel Crisp said he hoped the measures would help people quit smoking.

The HDA said it was taking such a strong line - it had previously been assumed a smoking ban would only apply to buildings - to send out a strong message about the dangers of smoking.

The success of this guidance will require a well thought out strategy of implementation by trusts in order to ensure that it is practical, flexible as well as desirable. Tom Sandford, of the Royal College of Nursing

HDA chairman Dame Yve Buckland said: "As the UK's largest employer, the NHS has a moral imperative to lead by example and promote the no-smoking message."

She also said there was evidence to suggest patients who continue to smoke while in hospital are at an increased risk of complications and delayed recovery.

The guidance said smoking at an entrance to a hospital can create a "very poor impression" and resources spent clearing smoking litter or building and maintaining smoking shelters could be better spent on treatment.

Complete ban

Under the white paper proposals, hospitals are not required to stop smoking in grounds, although it is expected they will ban it in buildings.

As yet, only a handful of trusts have introduced complete bans and 60% still have smoking rooms.

Tom Sandford, director of the Royal College of Nursing, said the guidance would help patients and professionals stop smoking.

But he warned: "The success of this guidance will require a well thought out strategy of implementation by trusts in order to ensure that it is practical, flexible as well as desirable."