Smoke Evacuation Regulations are Coming…Is Your Facility Prepared? 

  • Published: 12/4/2023
  • 3 Min
  • Updated: 7/8/2025

As of July 2025, legislation requiring surgical smoke evacuation in operating rooms has been enacted in 19 states. These laws apply to procedures that generate surgical smoke plume, which occur in approximately 90 percent of all surgeries.1 Additional states are actively considering similar measures, reflecting a growing national commitment to protecting perioperative staff and patients from the harmful effects of surgical smoke.

Since the summer, Ohio, Missouri, and Louisiana have all adopted laws to ensure smoke-free operating environments for their staff and patients. Washington and Connecticut are joining this growing list, with laws going into effect January 1, 2024.

Surgical Smoke Evacuation Legislation Status Map as of July 1, 2025

North Carolina is one of the most recent states to pass such legislation, requiring hospitals to implement smoke evacuation systems by 2026. The law was backed by the North Carolina Council of Operating Room Nurses and state lawmakers, who have long advocated for safer surgical environments.

Amanda Heitman, President of the Council, shared:

“We’ve been fighting this for several years now and we’re very, very happy that this has finally been approved. This is going to provide a safe environment free from those types of dangers”2.

1 Steege AL, Boiano JM, Sweeney MH. Secondhand smoke in the operating room? Precautionary practices lacking for surgical smoke. Am J Ind Med. 2016;59(11):1020-1031.
2 Surgical smoke ban signed into law, promises safer OR's across North Carolina - WPTF-AM

While many in these states are celebrating wins for a healthier working environment,
some are only just receiving the memo.

If you are preparing to implement smoke evacuation,
here are three considerations to ensure success.

Choice Improves Compliance

Asking surgeons to exchange their instruments for something new may spark hesitation. And rightfully so, as surgeons typically choose what enables them to best treat their patients and secure strong outcomes. By offering a range of options, you can increase the likelihood of matching the feel and performance of the device they’re most comfortable using.

Expertise
Matters

For many, this is their first time implementing smoke evacuation. Familiarity with guidelines and recommendations, portfolio options, and suggested trainings may be low. Partnering with an expert in this field can benefit you and your facility. Relying on the experience of those who’ve gone before can streamline the implementation process for your entire team.

Financing
Flexibility

If you did not budget for the effects of smoke evacuation legislation, you are not alone. Luckily, there are several options for healthcare facilities to secure the equipment you need today. Placement agreements, no interest financing, even no payments for extended periods of time are all options that some manufacturers can provide for their customers. If this factor is important to you, make sure you discuss these options with your smoke management partner.

The laws impacting surgical smoke management are designed to promote a safe and healthy operating environment for all perioperative staff and patients. If you are implementing smoke evacuation soon, consider CONMED and the Buffalo Filter brand. As the leader in smoke management, we can simplify the process for you from start to finish.

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