Introduction - The Ministry of Health assessed compliance with tobacco regulations in French public hospitals in the spring of 2006. Method - A stratified random sample survey was conducted in 2006. Sampling rates were adjusted to account for the size of the facilities. Staff, patients, and directors from 316 facilities completed a self-administered questionnaire, resulting in a 70% response rate. Results - In 2006, 67% of directors and 47% of staff considered smoking to be “a problem” in their facility. Hospital size, the size of the municipalities where they are located, and specialization in psychiatry generally increase the difficulties. At the time of the survey, a total smoking ban in hospitals was supported by 73% of directors and 46% of staff. Discussion - The situation in France was not unique in Europe in 2006. Conclusion - Approximately two-thirds of facilities reported difficulties in enforcing the 1992 regulations. The total ban on smoking in hospital buildings, effective as of February 1, 2007, will likely highlight the specific negative impact of the absence of provisions specific to healthcare facilities in the 1992 decree. (R.A.)