Fed-up bosses reluctantly decided to bring the shelters back after smokers frequently flouted the rules – and staff suffered growing abuse when they tried to stop them.

The shelters were removed in 2006, when smoking was outlawed from the hospital grounds, in addition to buildings, in a move described as "one of the biggest advances in public health in Sunderland".

But since then, smokers have regularly ignored the ban and are often seen puffing away at entrances to the hospital.

Les Boobis, medical director of City Hospitals Sunderland, said: "Our staff were getting subjected to increasing abuse and threats from smokers when they were trying their best to stop them."

"It was felt that the sensible thing to do is give people a place where we can insist they go to smoke, without smoking round entrances."

Mr Boobis added: "I find it very disappointing that responsible adults will continue to smoke right in the hospital entrance when they know they shouldn't be, and that the smoke is drifting into the hospital, upsetting staff and patients."

The decision to bring back smoking shelters was taken by City Hospitals Sunderland's boards of directors and governors.

Two shelters will be built – one adjacent to the main entrance and the other opposite the maternity unit.

Mr Boobis said he had opposed the return of the shelters because he felt it was an "admission of defeat" in combating smokers on site.

He added: "Smokers have got to look and reflect on what they are doing.

"Hospital is a place where sick people are looked after and staff have a right not to be exposed to second-hand smoke."

"We get complaints from relations and patients about smoke."

Mr Boobis says that the litter caused by cigarette butts is also a problem.

He added: "It is terribly untidy, there's a huge amount of litter.
City Hospitals Sunderland became a smoke-free zone on No Smoking Day 2006, when the new rules prevented people from lighting up anywhere on the trust's property.

However, there was no legal action that could be taken against people breaking the ban.

Mr Boobis said: "It's a shame the Government didn't introduce legislation that allowed us to enforce no smoking on site.

"If people feel we have no power they will just ignore us."