A smoking ban should be established in Newcastle city centre to benefit the majority of people, the Heart Foundation says.
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The push comes amid concern that more people living in the city will mean more smokers and second-hand smoke in the area.
"I would love to see Newcastle CBD smoke-free, particularly now it's becoming more dense with buildings," said Deborah Moore, Heart Foundation regional health promotion co-ordinator.
Ms Moore added that a smoke-free CBD would mean less litter, a better environment and improved human health.
She highlighted Darby and Hunter streets, Honeysuckle and Newcastle beach as prime spots for smoking bans.
Lord mayor Nuatali Nelmes said City of Newcastle was "supportive of any initiative aimed at improving the health of Novocastrians".
Cr Nelmes added that the council backed ways to improve the "liveability of our city and CBD for locals and visitors".
About 15 per cent of adults smoke in the Hunter-New England region. A long-term decline in smoking rates in the region has flatlined over the past five years.
"Unfortunately smoking attributable deaths in the Newcastle local government area do remain higher than the state average," Cr Nelmes said.
North Sydney Council voted last week to ban smoking in the streets of its CBD.
Cr Nelmes said Newcastle should follow a similar process to North Sydney Council.
"City of Newcastle should undertake broad community consultation with businesses and residents to ensure community support for any changes to their public spaces," she said.
A survey of residents and businesses in North Sydney found 80 per cent backed a ban, with most concerned that "second-hand smoke is bad for health".
Ms Moore said the push for smoke-free CBDs has, so far, won public support.
"From a health perspective, not breathing in other people's tobacco smoke is a big one," she said.
"We all know cigarette smoke leads to poor health. It doubles a person's chance of having a fatal heart attack."
In Australia, survival rates from heart attack are high.
However, smokers who have a heart attack are "twice as likely to have a fatal heart attack".
"It's a similar doubling effect on your chances of having a stroke," she said.
Smoking also increases the risk for cancer, diabetes, renal disease, eye disease and respiratory conditions such as asthma, emphysema and bronchitis.
"The longer people are not exposed to smoke, the healthier they are," she said.
"There are very clear benefits from a cardiovascular point of view from not smoking."
She said there was a "big majority of people" who don't want to be breathing other people's smoke.
Of those who do smoke, surveys show 80 per cent of them want to quit, but have trouble doing so.
Ms Moore says reducing areas in which people can smoke in public can help smokers quit.
"It reduces the number of times they can light up through the day," she said.
"We have to recognise that, for a lot of smokers, they desperately want to give up but the nicotine addiction is too strong."
Ex-smokers, too, would benefit from a smoking ban.
"If ex-smokers have environmental triggers that say 'you can't smoke here', that's supporting their decision not to smoke," she said.
Ms Moore said there was an "ongoing move towards a non-smoking society".
"It's not a personal attack on anybody, but the general health message is not smoking is good for you," she said.
Given local government elections will be held next year, Ms Moore said CBD smoking bans were "maybe something that councils need to think about".
She highlighted Cessnock CBD as another prime area for a smoking ban.
"Cessnock has a higher smoking rate than the state average," she said.
"We'd love to see a smoke-free Vincent Street, as the main street of Cessnock and a gateway to the vineyards."
In 2016, Tamworth Regional Council introduced smoke-free zones in its CBD.
Also that year, the NSW government banned smoking within four metres of access points to public buildings and 10 metres of children's play equipment.
The state ban also covers spectator areas at sports grounds and commercial outdoor dining areas, along with public transport stops and platforms.
Ms Moore said it was time for smoking bans to go further.
She said central business districts can become "quite heavy in smoke, with people smoking outside buildings".
"If you have three people smoking four metres away from the entrance to a building, depending on the wind, you could be getting a big whiff of smoke while walking into that building," she said.
She said smoking bans must include e-cigarettes.
"They reinforce the behaviour of hand-to-mouth smoke," she said, adding that they suggest to children that this behaviour is OK.
"People who don't want to give up may break the addiction cycle in some respects, but not the behavioural cycle."
