Not long ago, conventional wisdom held that psychiatric hospitals could not be entirely smoke free. Such policies, it was thought, would be impossible to enforce, and attempts to do so would increase the risk of patient violence and fires from clandestine smoking. Now we know that these concerns are unfounded. Well-implemented smoke-free policies have resulted in care environments that show improved outcomes in smoking-related incidents of restraint and seclusion, and staff resistance has not been insurmountable. In fact, patients and staff alike can and should be significant resources for successful implementation of smoke-free policies. Mental health care settings can create environments that promote a tobacco-free lifestyle to consumers, in the same way that virtually all medical centers and hospitals across the country have already done.