RPH acting executive director Aresh Anwar said the hospital had implemented several strategies to curb smoking .
These include audio messages at the entry points in Victoria Square and the multi-storey car park, signage, verbal warnings, newsletters and offering nicotine replacement therapy.
But former patient Phill Moncrieff, who used to work near the hospital, said it was not enough.
He said RPH needed to adopt a zero tolerance policy on smoking.
It was morally wrong for a public hospital to allow �chronic� smoking,� he said.
�On the south side entrance, I counted 16 signs and there were people standing within a foot of them and smoking,� Mr Moncrieff said.
Under the Smoke Free WA Health System Policy, smoking is not allowed on all premises and grounds of buildings owned by the Health Department and it applies to all staff, patients, visitors and contractors.
After Guardian Express reported about smoking outside RPH in March, Mr Moncrieff said he had still noticed smokers in prohibited areas.
�The bottom line is that it has to be a zero tolerance policy because the law is the law, and RPH is breaking that law,� he said. �On-the-spot fines would be great.�
Dr Anwar said some people still smoked outside the hospital despite concerted efforts by the hospital.
�RPH does not have jurisdiction over smoking on public footpaths, but our staff can and do ask people to move on when they are found to be smoking on grounds or too close to hospital entrances,� he said.
He added that the 2008 Smoke Free Policy brought about �significant change� in smoking culture around the hospital.
Australian Council on Smoking and Health president Mike Daube said it was difficult for RPH because they were dealing with public streets.
�The RPH clientele come from disadvantaged backgrounds and those are in groups with higher numbers of smokers,� Professor Daube said. �I sympathise with RPH and we have been working with them on this issue.�