The Scottish Government aims to make it an offence to smoke within 15 metres of hospitals, as part of a tobacco control plan which includes 44 specific actions.
The NHS in Scotland has spent years trying to persuade smokers not to light up in hospital grounds without success, and now intends to tackle the issue by bringing in new legislation.
However no final decision has been made on whether vaping should continue to be tolerated around NHS facilities - the Scottish Government aims to work with health boards and integration boards to “try and reach a consensus” on the issue.
The move is part of tobacco control action plan aimed at addressing health inequalities and cutting smoking rates, particularly in deprived areas.
Other moves include banning tobacco in prisons and “exploring” with local authorities the possibility of building anti-smoking rules into tenancy agreements.
There will also be renewed emphasis on preventing smoking take-up among young people, and on tackling the problem of adults who illegally buy cigarettes for under-18’s.
Public Health Minister Aileen Campbell said: “We all want to give our children the best possible start in life, and to protect them from harm as they grow up.
“One way we can all help with this is to fight the influence of tobacco over children and young people.
“Five years ago we set an ambitious target to create a tobacco-free generation by 2034.
“We’ve made good progress – halving the number of children exposed to second hand smoke, introducing plain packaging and cracking down on cigarette sales to under-18s.
“Now it’s time to set out our next steps”.
NHS Forth Valley says it supports “any new measures” to help reduce smoking on hospital grounds.
A spokesperson said: “We await further guidance on the new national legalisation and enforcement powers which the Scottish Government plans to introduce”.