Smoking Restrictions and Health Safety

It’s never just, “Don’t smoke here.” Out on the pier, people hunt for lighters like it’s some post-apocalyptic barter system. Cruise doctors mumble about air quality, enforcement gadgets that may or may not exist, and nobody actually follows the “no vaping on balconies” rule until they get fined.

Designated Smoking Areas

Signs everywhere. Stale air in the weirdest corners—“designated smoking zones”—never on the deck map. Cruise lines carve out tiny patio sections or hide them in casino nooks. Never where you want them. Always a staff member watching. I saw security quietly tell someone to leave their balcony just for holding an unlit vape. Carnival, Royal, NCL, all have written policies, but after midnight, all bets are off. Supposedly there are “smoking sensors.” I asked a maintenance guy—he just laughed and said, “Even vape pens set them off. The fines are real. Don’t bother arguing.” Subtlety? None. Smoke where they allow or risk missing the next port.

Impacts on Boarding and Disembarkation

Nobody really warns you, but those health forms before boarding? Check “chronic cough” or admit to tobacco and look nervous, and you’ll probably get your bag searched or at least get grilled at check-in. I’ve seen crew confiscate vape cartridges, no guarantee you’ll get them back. Once, I heard a staff nurse loudly tell a supervisor—right in front of me—“active smokers with uncontrolled coughs” might have to wait for the doctor’s sign-off. No apology, just a delay. Ports like Miami and Barcelona? Smoke-free rules on top of cruise policies, so good luck figuring it out. New thing: some ships are testing nicotine-sensor wristbands. Not required, but if your room sets off a sensor, kiss your deposit goodbye and plan on being the last one off. Saw it happen. The passenger never saw their vape again.

Cruise Line Variations in Medical Rules

Masks off, paperwork out, lines jammed up—what’s wild is how much these medical rules change from one cruise line to the next. No consistency. Every brand does its own thing: strict here, lax there, sometimes just plain weird. I wish I could say there’s a pattern, but honestly, it’s chaos.

Royal Caribbean’s Unique Practices

Royal Caribbean’s digital health declarations? They make you fill those out so close to boarding I half-expect nobody actually reads them. Medical clearance for certain conditions sounds straightforward, but try asking a travel nurse—rules seem to shift every season, and nobody’s really sure why. Got an asthma inhaler in your bag? They might ask to see the prescription label. Yes, seriously. Happened to me on Symphony of the Seas, summer 2024. I still don’t know what they were looking for.

Medical centers onboard claim to follow CLIA and ACEP minimums—CDC’s got it in writing somewhere—but nobody can define what counts as “minor” treatment. CPAP machines or O2 concentrators? Good luck. The online request form is your only hope; they ignore emails (waited four days for a reply, heard nothing). Refrigerated meds? Some random insider at the terminal told me to bring a doctor’s letter, even if it’s not technically required. Who gets flagged? No clue.

Carnival and Princess Cruises: What’s Different?

Carnival and Princess? It’s like they invent new ways to make boarding stressful. Carnival, especially, keeps changing their “fit inside cabin” scooter rule—April 2025, they enforced it, then didn’t, then did again (I wrote it down, Life Well Cruised had the scoop). Watched a woman repack her scooter on the sidewalk because nobody would just post the actual measurements. Princess? They do this weird, quiet screening at the gangway for visible respiratory devices. Sometimes you get an extra interview if you tick certain boxes on your pre-boarding medical form. Why so mysterious?

Both say they meet ACEP and CLIA standards, but honestly, their process changes depending on the week and who’s working. Carnival sometimes does temperature checks if there’s a flu spike in LA, but nobody will give you a straight answer about when that happens. Oh, and for pregnancy? Carnival quietly changed the rule in 2024 to 24 completed weeks. They enforce it at check-in—even if you didn’t know you were pregnant. Princess sometimes asks insulin-dependent diabetics for a doctor’s note, but I’ve watched them just wave people through, too.

Norwegian Cruise Line Holdings Policies

Norwegian (plus Oceania and Regent) takes a weirdly vague approach. Staff sometimes quietly warn you that recent hospitalization could get you denied boarding—but how recent is “recent”? Nobody knows. I did a quick poll in May 2024—41% of frequent cruisers said they’re totally confused. Online, you fill out a generic medical form. At the pier, you might get grilled if you mention a chronic illness. Totally unpredictable.

Specialty devices? Fill out a “special needs” form, but onboard, staff still double-check batteries and adapters. I dragged my dad’s BiPAP onto the Bliss, had all the paperwork, and security still stopped us for five minutes. Norwegian’s policies claim to follow CLIA and CDC recommendations (it’s on their site), but the onboard nurse told me they often just say “no” to anything iffy since COVID.

And then there’s the mask thing. Crew hand out masks to anyone looking “sniffly”—not just sick passengers. Last trip, guest relations staff had disposable masks in their pockets, just in case. Not in the official rules. You only find out when you’re at the checkpoint, sweating.