Surgical Smoke Evacuation Bills Across the Country in 2025

Nurses across the country from Hawaii to Massachusetts have been working diligently on surgical smoke evacuation legislation in 2025. To date, nine states – Arkansas, Florida, Hawaii, Massachusetts, North Carolina, Oklahoma, Pennsylvania, South Carolina and Texas - have introduced bills to address harmful surgical smoke and the need to implement statewide requirements to protect perioperative nurses, their colleagues and their patients from the hazards prevalent in surgical smoke.

This year was a “year of firsts” for smoke evacuation legislation, with bills introduced for the very first time in Arkansas, Hawaii, Oklahoma, and South Carolina. In Arkansas HB 1718 was introduced in March by Rep. Zack Gramlich. The bill had a hearing in the House Public Health, Welfare and Labor Committee on April 8 but failed to advance this session. The Arkansas bill will have to be reintroduced in 2027.

Hawaii HB 218 and SB 393 were both introduced in January and assigned to committees but failed to advance this year. Oklahoma HB 1887 and SB 933 were introduced on February 3 in their respective legislative bodies but both faced opposition from the Oklahoma Hospital Association.

South Carolina S. 170, introduced by Sen. Greg Hembree in January, passed the Senate unanimously in March and awaits consideration in the House Medical, Military, Public and Municipal Affairs Committee when the legislature reconvenes in 2026.

In other states, surgical smoke evacuation legislation was put on the legislative agenda for a second or third time. In Massachusetts, North Carolina, and Pennsylvania, surgical smoke evacuation legislation was introduced again after failing to advance in the previous legislative session. Pennsylvania HB 27 and North Carolina HB 390 have both passed their respective Houses and are under consideration in their state Senates. In Massachusetts H.2442 and S.1482 were introduced in February and referred to the Joint Committee on Public Health. The legislative sessions in all three of these states are two-year sessions, and AORN is hopeful that one or more of these states will go surgical smoke-free in the coming months.

This year was the third year that the Florida legislature considered surgical smoke evacuation legislation. Both the House and Senate bills saw action in their respective committees but failed to advance this year. AORN and the Florida Nurses Association will convene this summer to debrief and plan for another attempt at legislation. Similarly, the Texas legislature took up surgical smoke evacuation legislation for a third time in 2025. HB 513 was on the calendar for a full House vote on Thursday, May 15, but was not taken up before the deadline at midnight.

AORN will continue to press for passage of these types of surgical smoke evacuation initiatives and advocate for surgical smoke-free operating rooms. AORN members can get the most up-to-date information on smoke evacuation bills on AORN’s website.