Is public health policy based on scholarly evidence? With the manifold variables that policy makers must consider, is evidence-based policy even realistic? While strategies exist to translate research into policy, a need to understand better how that can play out in real-life remains. Using interviews from informants occupying a range of positions, and considering the atmosphere created by media reports, this study examines the case of smoking privileges at East Coast Forensic Hospital. After a patient committed murder while on leave, apparently to smoke, public pressure over public safety, a relative lack of relevant scholarship, ethical considerations, and the divergent voices of stakeholders created challenging circumstances for policy makers. Through the use of case study methodology, this project identifies the kinds of information that are employed in the creation or modification of policy and offers insights concerning how the influences exerted on policy makers determine how information is employed.