Smoke-free health care environments are now the norm in Australia and exemplify the way in which environments for health care can become more health promoting. Community health services that assist people with chronic illnesses and disabilities to increase control over their lives, hospitals that provide nutritious food choices for staff and patients, and general practices that encourage routine preventive care throughout the life span are other examples of health-promoting environments. In their roles as providers of services, employers, community corporations and citizens, health care organisations have a wide range of opportunities for developing their capacity for health promotion. These include transforming the principles and values on which service delivery models are based, developing an organisational capacity for health promotion through staff training and designing programs, services and facilities to promote health. While some industry accreditation programs are evolving to embody specific elements that are health promoting, significant barriers to this area of organisational development continue to exist. These include disincentives linked with health care financing and the values, priorities and skills of health care workers who must turn rhetoric into practice. Just as the introduction of smoke-free environments success on research findings and a supportive political and social milieu to be successful, the further development of environments for health care which are health promoting in other ways will need to be driven by evidence and advocacy.