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Smoking outside hospitals is now banned under new legislation.
Anyone caught lighting up within 15m of a hospital building in Scotland could be fined up to £1,000.
The regulations become law from Monday, and apply to all NHS hospital settings used for patient treatment and care.
The new rule follows a voluntary smoke-free policy introduced at hospitals in 2015 and is the latest step in the Scottish government's plan to create a tobacco-free Scotland by 2034.
Fines for the new offence will range from a fixed penalty notice of £50, or a fine of up to £1,000 should the case end up in court.
The rule applies to NHS hospital settings used for patient treatment and care, and includes a ban on smoking beneath overhanging structures.
Sheila Duffy from Ash Scotland hopes it will prevent tobacco smoke being drawn in through windows, doorways and vents.
She told BBC Radio's Good Morning Scotland: "It has effects on the blood, it has effects on the lungs and it interferes with people getting well, which is what they are in there to do.
"There are newborns and people who are ill in hospitals and this measure is about creating cleaner air for their stay and making sure that they get out as healthy as possible.
"This is a toxic substance. It is preventable and is not a welcome addition to the indoor air in hospitals."
She also hopes the prospect of fines will make people change their habits.
"A fine would absolutely be a last resort and I think it would be a failure if we got to fines," she said. "We need people to understand and respect this as they have the indoor restrictions."
Hospital authorities - those who are already responsible for enforcing indoor smoke-free legislation - will implement the new rules.
If a facility has persistent problems, environmental health officers can be asked to intervene and issue a fixed penalty notice.
Public health minister Maree Todd said: "Everyone knows that smoking is bad for our health and hospital patients in particular should be protected from the harmful effects of second-hand smoke.
"This new law is the latest step in our bold plan to make Scotland tobacco-free by 2034, building on our dedicated stop-smoking services and early intervention measures to stop youngsters picking up the habit altogether.
"Anyone looking to quit can contact the NHS QuitYourWay Helpline or speak to their local pharmacy to discuss the range of help available."