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Hospitals have had no smoking in the hospital rules for years.  (This is in humorous contrast to when my father was smoking in the physician lounge in the 1960s.)

A Salina, Kansas hospital has a way to get patient to observe their no-tobacco rule: They’re being sent home.  Salina health Center and its clinics have been tobacco-free since 2007, but have had difficulty with patients continuing to sneak cigarettes or chewing tobacco. 

Starting August 2014, patient were warned that tobacco use would warrant discharge from the hospital and a notation of the chart of having “left against medical advice (AMA)”.  This AMA status is financially significant in that many insurance companies will refuse to pay for any of the hospitalization if the patient leave the hospital AMA.

I wonder if this will be the tip-of-the-iceberg?!  We will see.