A new initiative in Massachusetts is drawing attention to the dangers of smoking when medical oxygen is being used in the home. A public service campaign has been organized by the state fire marshal’s office and Massachusetts General Hospital to make patients and their loved ones and other caregivers aware of this underappreciated home hazard. A fire needs oxygen to start and to keep burning. When more oxygen is in the air because of home oxygen use, a fire will burn hotter and faster. Smoking should never be allowed in a home where oxygen is used because it is such a risk factor for fire, not to mention its negative effects on health in general. Even if the flow of medical oxygen has been stopped, it may have saturated clothing, curtains, furniture, bedding, hair—in short, anything in the surrounding area, say experts at the National Fire Protection Association. So just turning it off is not a green light to light up. Many burn injuries involve the face because many personal products, from hairspray to the ointment lung patients use on their nose to avoid irritation from the oxygen tube is flammable. Experts also caution that the elderly, especially those unable to easily escape a fire, are particularly vulnerable. Roughly 200 home fires a year are related to oxygen use, with fatalities occurring in about a third of the incidents—figures that could be on the conservative side. Any lung patients who still smoke should be encouraged to join a quit smoking program for their sake, the sake of others living in the home and that of any neighbors who could be affected by a fire.