Background: Policy is a statement of organisational vision. Its purpose is to direct an organisation towards results. If policy is ambiguous, vision is blurred and achieving results less likely. A content analysis of New Zealand DHBs' smokefree policies, undertaken in 2003, found that 14 of 18 policies analysed allowed some smoking by some people in some places at some times. Four stated that all DHB buildings, vehicles and grounds were totally smokefree, and just one included a commitment to the systematic identification, recording and acting on patient smoking. During 2004, the Systems First project was launched to support hospitals in achieving a best practice standard of care for patients who smoke. Discussion: This presentation will describe the current status of DHB smokefree policies in general and the policy review process various hospitals have followed. Policy review has been a first and key step in strengthening smokefree action. A shift has been needed from an almost exclusive policy focus on smokefree settings to one that encompasses commitment to more smokefree people. Supporting documents have been used to explain the rationale, and evidence base, for the proposed changes. Changes have been communicated to staff via various means including DHB internal newsletter (“It really aligns our policies with our business and values – which are about health and wellness.”) and incorporated into ongoing orientation and training programmes for staff. The revised smokefree policies have enabled a flow of focused action to follow. Conclusion: Strong smokefree policy directs an organisation towards improved health.