Background, In an effort to learn more about the smoking behavior of hospital employees, a study was conducted at the University of Kansas Medical Center (KUMC) regarding tobacco usage and secondhand smoke exposure. Methods. An anonymous voluntary survey was distributed to 4177 full-time employees in Kansas City and Wichita during June and July of 1998, Questions included tobacco usage and exposure to secondhand smoke. The survey results were assimilated in a database, which was analyzed in a variety of ways to arrive at several conclusive findings. Results. Of the 1187 respondents (28.4%), 35.1% had smoked at least 100 cigarettes in their life (41% of those had at least a 10 pack-year history), and 11.8% currently smoked. The groups with the highest percentage of current smokers were females (12%), blacks (17%), Kansas City campus employees (12%), and nonfaculty (13%). Sixty-seven percent of respondents were exposed to secondhand smoke in the previous week, and 25% were exposed at KUMC. Conclusions. After arriving at the results of this study, recommendations include starting an educational campaign against smoking, promoting cessation programs, moving the current smoking area to a less populated area on campus, and investigating a total campus ban on smoking. (C) 2000 American Health Foundation and Academic Press.