Smoking on campus comes to a final crossroads.

“Smoking tobacco remains the leading preventable cause of death in this country and secondhand smoke is known to be a cancer-causing agent,” said Zerhouni. “Devastating cancers are caused by chewing tobacco products. To protect the health of all who work at or visit the NIH, it is imperative that we become tobacco- free. Effective Oct. 1, use of cigarettes, cigars, pipes, smokeless tobacco and any other tobacco products is prohibited on the NIH Bethesda campus.”

Enforcement of the new policy will be administrative, not judicial; managers and supervisors will be responsible for assuring that all employees comply. “Supervisors are responsible for ensuring all employees are notified of and receive a copy of the new policy,” Zerhouni explained. “Supervisors should apply the same administrative approach that they use to address violations of any NIH policy and should consult with an NIH employee relations specialist for advice on appropriate action to take regarding observed or reported violations.”

From Oct. 1 on, tobacco use on campus will be limited only to patients whose attending physicians have formally permitted them to smoke (and then, only in a designated area outside the hospital) and to residents of on-campus homes. No ashtrays, butt cans or smoking shelters will be provided on tobacco-free campus grounds.

One other caveat: members of the four unions represented on campus (the largest of which is AFGE—the American Federation of Government Employees) can, technically, still use tobacco because they have not yet renegotiated a collective bargaining agreement with NIH that allowed tobacco use. Although the agreement expired in August 2005, a new one has not yet been signed.

Off campus, at all other facilities owned by NIH, employees will continue to follow the 2002 NIH smoking policy or local policy that is facility-specific. Leased facilities will continue to follow local ordinances and the federal statute prohibiting smoking in a federal workplace.

NIH has wrestled with a number of thorny issues in a quest to go tobacco-free that began at least as long ago as 1987’s “Smoke Free, And Happy To Be” campaign, which ended smoking in campus buildings. In addition to the union and patient-care issues is the problem of the sheer size of campus: if a supervisor permits a smoke break, it’s likely to take someone at the heart of campus—say in Bldg. 30—a half-hour or more to walk off campus, where smoking rules don’t apply.

Some supervisors have faced the following “disparate treatment” dilemma: if they let smokers take two or three breaks a day, the nonsmokers resent the de facto gift of annual leave granted smokers and end up demanding ad hoc leave of their own, out of fairness.

No policy is going to please all parties. Under the pre-Oct. 1 rules, the biggest complaint from employees has been second-hand smoke: smokers tend to congregate just outside building entrances, creating a haze that nonsmokers must negotiate. And some on campus are worried that the post-Oct. 1 policy will harm NIH’s ability to recruit foreign scientists from countries where smoking is still popular and widespread.

One reason that NIH leadership is keen to pursue tobacco-free status is the agency’s reputation as a beacon of enlightened health policy. “It looks pretty bad to someone from, say, NCI’s board of scientific counselors, to visit the NIH campus and see that smoking is still permitted here,” said one long-time NIH’er.

NIH employees who smoke and want to quit will continue to be offered free smoking-cessation programs. The web site http://tobaccofree.nih.gov, which debuted in 2005, has been updated and now reflects the policy that takes effect Oct. 1.

“When we established a web site for the NIH tobacco-free effort, we titled it ‘Taking Our Own Best Advice.’ We want a healthy and productive NIH community,” Zerhouni said.