"What will be the next step, that you can't be five pounds over your ideal weight? As ludicrous as it may sound, I see it going there," said Vanessa Vaughn, who's worked at the hospital for four years.

"It would be just like them telling these other people they had to smoke," added Sue Jeffress, a patient's wife. "They're telling us we can't smoke, and I think it should be a personal choice."

But the ban's supporters heard several speakers on Thursday who talked about a healthy role model.

"We're very proud to take the leadership in the community and be one of the first hospitals to implement a tobacco-free, inside and out, policy," said Dr. Laura Schopp. "This policy has worked elsewhere. It has been implemented in hospitals nationwide."

Dave Dillon of the state hospital association added, "Things that hurt people's health, that they do deliberately, are not going to be allowed in hospitals. We have a definite role in leadership on things that are detrimental to health."

The association said at least 140 Missouri hospitals have banned smoking.