Non-smoking rules are being flouted by patients and staff in two-thirds of NHS hospitals and have led to an increase in litter, according to researchers.

Research published in the journal BMC Health Services Research asked three quarters of acute and mental health trusts about the implementation of smoking rules.

It also found half of acute trusts and 78 per cent of mental heath settings had in place exemptions to the ban, typically for bereaved families and mental health patients.

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