Background:
Most states in the U.S. permit hotels to allow smoking in some guest rooms, and only five (Indiana, Michigan, North Dakota, Vermont, and Wisconsin) require that all hotel and motel rooms be 100% smoke-free (State and local 100% smokefree hotel and motel guest room laws enacted as of July 3, 2017). Little is known, however, about how hotels’ smoking policies have been implemented. This study examined hotels’ smoking policies and their implementation.

Methods:
A telephone survey of a random sample of 383 California hotel managers was conducted.

Results:
Overall, 60.6% of hotels reported that smoking was prohibited in all guest rooms, and 4.7% reported that smoking was prohibited everywhere on their property. While California law permitted smoking in up to 65% of guest rooms, only 6.9% of rooms were reported as smoking-permitted. Over 90% of hotels had smoking rooms scattered among nonsmoking rooms, and about half of the smoking hotels reported that guests requesting either smoking or nonsmoking rooms were sometimes assigned to the other room type. When guests smoked in nonsmoking rooms fees could be substantial, but were often uncollected.

Conclusions:
Hotel smoking policies and their implementation fall short of protecting nonsmoking guests and workers from exposure to secondhand and thirdhand smoke. Complete indoor smoking bans for all hotels are needed to close existing loopholes. Nonsmokers who wish to protect themselves from exposure to tobacco smoke should avoid hotels that permit smoking and instead stay in completely smoke-free hotels.