Constant warnings and clampdowns have failed to stop health professionals, contractors and patients sneaking a crafty cigarette when they can.
Walsall Healthcare NHS Trust has also been forced to build a secure unit, surrounded by security cameras, to stop laughing gas (nitrous dioxide) and liquid oxygen being stolen.
A health and safety report noted: "There is an increase fire hazard risk due to individuals smoking next to storage areas around the trust that contain flammable liquids."
The problem has dogged the trust for two years, with the Walsall Healthcare Risk Register showing attempts to stamp it out dating back to 2019.
In January 2022 the solution was: "No Smoking Policy to be ratified and rolled out, clarifies the support offered to patients and staff, to enable a smoke free environment. As well as holding staff to account of breaching the No Smoking Policy."
A year later "new no smoking signage" was installed, however, smokers still ignored the signs, leading to in May this year, the next "action" to solve the potential deadly problem was: "CCTV installation upgrade, to cover prime smoking spots."
The trust also blamed contractors for lighting up near the flammable liquids. The risk report said: "Staff from external security contractor have been formally written to by their employers to avoid any breaches regarding this process."
A trust security report revealed security was beefed up around liquid oxygen storage, The report said: "Cameras are now in place around the storage area, the storage area has been increased to four reserve tanks to improve resilience. The new compound for the increased oxygen is being built and there will be cameras on this once completed."
Walsall Healthcare Trust has previously refuse to disclose how much nitrous dioxide has been stolen from its premises. When asked two years ago in a freedom of information request, the trust refused to give an answer.
It said: "This information is exempt from disclosure in accordance with section 31(1) (a) the prevention or detection of a crime. The trust determines that to disclose the location, number and volume would prejudice the trust’s ability to prevent and react to possible theft."