Health chiefs are calling for smoking to be completely banned in all NHS buildings and grounds.
Public Health England is campaigning for a "tobacco-free NHS" with more support on quitting offered to patients, visitors and staff.
Duncan Selbie, chief executive of PHE, said he wants every hospital's buildings and grounds to be completely smoke free.
"25% of patients in hospital are smokers," he added.
"I believe we can make the NHS a place that provides a supportive tobacco-free environment for patients, staff and visitors, where helping people quit is fully integrated into their treatment."
Many hospitals are already smoke-free in their buildings and grounds, but some patients, visitors and staff flout the rules.
In an open letter to all NHS trusts Mr Selbie wrote: "I am asking for your help to reach smokers who are in your hospital waiting rooms, consulting rooms and beds.
"There is a clear opportunity to achieve significant short-term savings and reduce demand."
Tobacco is the single biggest cause of premature death in England, costing the NHS an estimated £2 billion every year and another £1.1 billion in social care, according to PHE.
Around seven million adults in England smoke and for every death caused by smoking there are around 20 suffering from diseases.