Smoking cessation services are well established in the community. In recent years, an increase in their availability has been recommended and secondary care settings were identified as suitable locations. This article draws on the evidence base underpinning this move and uses findings from an evaluation of such a service introduced into an acute hospital to illustrate the key principles to be considered. These principles included receptiveness of the hospital environment to the smoking cessation message, the importance of organizational preparation before launching the service, collaboration within the hospital and in the community, resourcing of the initiative, training of staff and providing feedback to staff on progress (e.g. quit rates resulting from initiative). The paper concludes that broad acceptance at all levels within the hospital, which enhances a stop smoking culture, in parallel with an in-depth preparation and training period, is required to successfully launch a hospital-based stop smoking service.