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Missouri Kicks Off the Year with Surgical Smoke-Free Legislation


The state of Missouri kicked off the new year with many new laws going into effect. While many are important and will make things better for the citizens of my state, the most important bill that passed, at least in my opinion, was HB 402: Missouri’s Surgical Smoke-Free Law.


As many of you know, there has been a strong push for states to go smoke-free. We were proud to become the 14th state to take this step on July 6, 2023, when Governor Mike Parson signed the bill into law, with it officially going into effect on January 1, 2026. This law requires hospitals and ambulatory surgical centers (ASCs) to develop and implement policies to eliminate surgical smoke.


This legislation doesn’t just protect perioperative nurses and surgical technologists, it also protects our patients.


We’ve All Heard the Dangers of Surgical Smoke

Surgical smoke:

  • Contains carcinogens

  • Can carry viruses such as hepatitis B (HBV)

  • Consists of toxic chemicals, including cyanide

  • Increases the risk of respiratory problems

  • Amplifies the risk of other medical issues, such as headaches, muscle pain, and genetic mutations

  • Can transmit diseases such as human papillomavirus (HPV)


As of October 16, 2025, 19 states have enacted surgical smoke-free laws, and 6 more have legislation pending for 2026. That’s 25 states down and 25 to go. We still have a lot of work to do to make the entire country smoke-free.


States Pending Smoke-Free Legislation for 2026

  • Florida

  • Hawaii​​

  • Iowa

  • Massachusetts

  • Michigan

  • Pennsylvania

  • South Carolina

  • Wisconsin


Is your state on this list? If it isn't you can be the voice of change! Nurses have the power to create change. It’s already been done, and it will continue to be done in the future. You can be part of that change. There are many resources available to help you become an advocate, so use them, raise your voice, and help move this movement forward.


Here are a few ideas and resources to help you learn more:

  • Share with co-workers the hazards of surgical smoke :

  • There are numerous smoke evacuators on the market: Stryker, ConMed, Medtronic, Johnson & Johnson, and others!  Work with your local reps on providing in-services on these devices with both staff and surgeons.

  • Contact AORN. They have been very influential in helping nurses in states to get smoke free bills into legislation. 

  • You can also contact nurses in states that have already passed legislation and ask how they went about getting a bill in front of their state’s government

    • If you would like to be connected to someone, just leave a comment and we'll provide the introduction!


There are still 25 states that don't have laws in place protecting us and our patients from the dangers of surgical smoke. Let's make 2026 the year for advocacy and change for ALL of us!


Lindsey


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