Introduction:
It is of huge concern that tobacco causes health debacle for citizens, who have universal right to protect lives. In Bangladesh, by law, health care facilities are 100% smoke free. In reality, it is yet to attain. It is evident that there is no risk-free level of secondhand smoke (SHS). Recent Global Adult Tobacco Survey Bangladesh 2017 states that, 12.7% of adults were exposed to SHS who visited health care facilities (HCF). So, quick policy decision is a dire necessity.

Objectives:
A government seeks evidence to get the real picture of any problem. So, National Heart Foundation of Bangladesh conducted a compliance survey to explore the latest situation of government HCFs to support in promulgation of necessary actions.

Methods:
A cross-sectional study of Quantitative-Qualitative variety was conducted in April, 2019 covering 51 government HCFs of Dhaka City. Of those, 41.2% were outdoor clinics and 58.8% were hospitals. Skilled data collectors took interviews vis-à-vis and assessed HCF buildings and premises at rush hours for evidence of smoking and smokeless tobacco (SLT) use. They also observed whether there was any anti-tobacco signage, provision of support for quitting and presence of point of sale of tobacco product in and around the HCF.

Results:
Direct and indirect evidence of tobacco control act violation was observed in HCFs. Smoking was found in 82.4% premises. Butts were found in 68.6% campuses and 43.1% building. Odor of smoking was found in 17.6% HCFs. In 45.1% HCFs, someone was found to use SLT within campus and in 41.2% it was within building. Tobacco consumption was higher in hospitals than clinic. Cessation clinic was present in one hospital only.

Conclusion(s):
Tobacco free government HCFs were scarcely found in Dhaka city. HCF personnel, patients, and attendants should be acquainted with law. Precedent emphasis is required to monitor breaches and apply penance. Novel approach is crucial to offer quitting.

Funding:
It was funded by CTFK.