Introduction:
In 2010, the government of Poland passed an amended smoke-free law that strengthened existing tobacco control policies and banned smoking in hospitals. The aims of our study are: to determine the state of smoke-free practices in Polish hospitals, and to identify challenges facing hospitals implementing smoke-free practices.

Material and methods:
In 2018, a cross-sectional survey was conducted on a representative sample of 100 hospitals operating in Poland. The research tool was the ENSH-Global Self-Audit Questionnaire. The questionnaire included 48 items related to the various aspects of smoke-free policy implementation in the hospital.

Results:
Among the surveyed hospitals, public entities were the dominant group (79%). The mean score for all analyzed standards was 78.55 points (out of 144 maximum available), with no differences (p = 0.4) between public and private entities. All hospitals surveyed displayed signage with information about prohibited tobacco products and tobacco-free campus boundaries. Hospital staff (95%) and service users (98%) reported a basic level of understanding of the hospital’s tobacco-free policy and the available tobacco cessation services. However, tobacco-free policies, in line with the ENSH-Global Standards, were implemented in 61% of surveyed hospitals. More than half of the hospitals (64%) do not currently assess tobacco use or provide tobacco dependence treatment services.

Conclusions:
Overall, smoke-free policies in hospitals operating in Poland are compliant with the National Tobacco Control Act and provide a smoke-free environment for service users and staff. However, continued monitoring and evaluation of tobacco control activities are necessary to promote the importance of smoke-free environments.