Summary

The Department of Veterans Affairs (VA) runs the nation's largest health care system, serving veterans in 158 medical centers. VA announced in 1989 its intent to prohibit smoking inside all these medical centers when outside smoking shelters were available. In November 1993, however, Congress passed legislation requiring VA to establish smoking areas in its facilities for veterans' use. This report examines the feasibility of establishing and maintaining the mandated smoking areas. GAO discusses (1) how the law might affect VA medical facilities' accreditations, (2) how much the facilities might spend to establish mandated smoking areas, and (3) how long the facilities might take to build these areas.

GAO found that: (1) VA medical facility accreditation will not change if the facility establishes mandated smoking areas; (2) 153 out of 159 VA medical facilities have at least one indoor or outdoor smoking area available to patients; (3) only 44 of the 153 facilities have at least one designated smoking area, either inside a patient care building or outside the facility, that meets the law's mandate; (4) the total cost of providing smoking areas in VA facilities will vary depending on the implementation strategy VA decides to use; (5) it will cost approximately $6 million to construct at least one designated smoking area at each VA facility; (6) most of the medical facilities could construct a mandated indoor or outdoor smoking area in less than 17 weeks; and (7) the establishment of smoking areas in VA medical facilities appears feasible, since VA facilities have the capability to construct these areas using separate ventilating systems and other environmental safeguards that minimize the potential health risks of tobacco smoke.