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Smoking is the leading preventable cause of death and the source of numerous problems in the workplace. This study assessed the smoking in health care workers in a general hospital in Central Italy. As part of the health surveillance required by Law No. 626/1994, 2743 employers (40.8% males, 59.2% females; mean age 42.0 ys, SD 9.6 ys) were interviewed. The prevalence of smokers was very high: 36.0% in men and 36.7% in women. When the population was stratified according to occupation, the highest prevalence of smokers was found in ward orderlies (45.2%) and nurses (38.9%) and the lowest in doctors (26.3%). The prevalence of smoking was similar in all occupational divisions--clinical, surgery, diagnostics and administration. This study shows that smoking is more widespread in hospital workers than in an age-matched section of the general population (27.5%). As all health workers should set a positive example in combatting smoking, occupational physicians in charge of health surveillance in hospitals should actively collaborate in smoking dissuasion programmes.