Yet on Tuesday afternoon, at least five visitors were lighting up at the entrance of the emergency department under no-smoking signs and next to patients. One patient was smoking while holding an IV pole.

When Terri Henderson and Jim Emerson were sitting by the hospital's back doors three days earlier, they filled up six sandwich bags full of cigarette butts in five minutes without moving from their seat.

Both members of Canberra Action on Smoking and Health (ASH) are fed up with the constant complaints about people smoking on restricted grounds, including at Canberra Hospital.

This is despite the significant drop in reported smoking at the hospital since it went entirely smoke-free in September 2014.

Figures show the number of cautions ACT Health security guards issued on the campus fell by 50 per cent to 248 last September, then to 192 in December.

However, an ACT Health spokesperson said the government could sanction only people who smokedinside Canberra Hospital buildings, or who smoked in a car with children at the campus.

They said only police and authorised public servants could issue fines for smoking in a legislated smoke-free area, which according to the Smoke-Free Public Places Act 2003 is $150 for an individual and $750 for a corporation.

ASH vice-president Mr Emerson is "shocked and appalled" at the lack of enforcement at the hospital and the continued littering of cigarette butts.

"There should also be a consistent policy for all patients who present to hospital – not just inpatients, but also outpatients and visitors – to receive support to stop smoking."

Nicotine-dependent smokers who are inpatients or working at the hospital are provided with free nicotine-replacement therapy, including patches or gum. They are also offered counselling.

While some smokers ignore the smoke-free zones, others move to the perimeter of the hospital grounds, along Yamba Drive, to light up.

Last year, Health Minister Simon Corbell foreshadowed the possibility of laws to stop people from smoking there.

Legislation passed this month that enables the Chief Minister and Health Minister to declare new smoke-free public places or events.

But an ACT Health spokesperson said the area along Yamba Drive was not being considered right now.

"Prior to a smoke-free area being established ... the ACT government will thoroughly assess associated costs and benefits, including health and business or economic impacts," they said.

"Priority will be given to exploring smoke-free options at places used by children and their families, including playgrounds, sporting fields and bus waiting areas."

Zlata Sidiropoulos, who moved to the grass area in front of the hospital to smoke, said she was "ashamed to see people smoking near the ED".

"A lot of people are stressed around here, so they should be able to smoke somewhere, but it's terrible how many people ignore the no-smoking signs and smoke right near the door," she said.

A group of hospital staff who were smoking along Yamba Drive felt only staff were penalised for smoking on campus.

"It's really unfair that we always see patients and visitors smoking on campus but we have to walk all the way down here or we could get punished by management," one worker said.

"It's also scary to walk down here at night when it's dark and dangerous."

Another worker said they'd noticed cigarette butts littered everywhere since the removal of designated smoking areas and ashtrays.

Health Services Union organiser for the ACT, Bev Turello, said the issues could be addressed by putting up more signs and did not think stronger enforcement or an extension of smoke-free zones was necessary.

She was referring to the end of last year when the government added 23 smoke-free campus signs to the 65 signs put up in July 2014.

"People are usually there for a traumatic event in their life, and I do feel there are certainly circumstances where they should be able to smoke," Ms Turello said.

"But if staff are doing the wrong thing there is a process that can be followed."

The process can include disciplinary action under their employment contracts.