Health managers have drawn-up plans for a ban on smoking at two Nottinghamshire hospitals.
It could lead to the closure of designated smoking rooms for staff and patients at Kingsmill Hospital in Sutton-in-Ashfield.
The current no-smoking policy at Kingsmill allows staff and patients to smoke in specified areas.
But a report for board members of the North Nottinghamshire NHS Trust suggests Kingsmill and Newark Hospitals could become total no-smoking sites.
It says the trust needs to adopt a greater health promotion role.
The report also says a lot of time is taken up by people having smoking breaks.
It estimated an average five minute break per hour adds up to about a whole afternoon a week.
The report questioned whether NHS money should be used to subsidise staff to smoke.
But it also recommended that if the hospitals become totally smoke-free, adequate support should be given to staff and patients.