ziptravel, we've run into the problem occasionally. These are not chain-specific comments, however.
First, we check and see how bad the room is. We've noticed how much worse smoking rooms have gotten over the years. It used to be that random usage meant most rooms got smoked in some of the time, but had a chance to "air out" in between smoking occupants. Now, if you get stuck with a smoking room, it's likely to be foul. But occasionally a smoking room only falls into the "bad but tolerable" category.
I do insist on being moved if it's at all possible.
If they can't move us, because the hotel is full, if it's really late & we're only there for one night, etc. we'll take the smoking room and just suffer. If we need to stay longer, most hotels will do their interim de-smoking thing, with ionizer and sometimes carpet shampoo, if you ask. We have also asked for all the linen to be changed and towels, etc. to be replaced. I sometimes wake up with stuffed head and sore throat anyway, but them's the breaks.
I've never considered that I was owed a comp over the issue. Even the best hotels, with the best intentions, can't always give everyone everything they want all the time. And I suspect that even a "confirmed" n-s room is not the same as "guaranteed."
If the issue is that you simply can't be in a smoked-up room because of a severe health problem, I guess checking out may be the only option. Then write Hilton, because I think they would owe you a comp night.
A complaint to corp. might also be in order if you discovered there were n-s accomodations (i.e. suites) available that the hotel refused to put you in. At least in the case you mention, they did the right thing for you in the end.
wharvey wrote, "I have colleagues I "yell" at... they smoke... but actually ask for non-smoking rooms. They go outside to smoke...
Better than smoking IN the non-smoking rooms. I suppose they're attempting to control how much they smoke by making it inconvenient to just light up at the slightest urge? Yell at them for me, too. If they won't quit, they can at least leave the n-s rooms for non-smokers.