Release Date:  June 6, 2001

RFA:  RFA-AG-01-006

National Institute on Aging

Letter of Intent Receipt Date:  August 14, 2001
Application Receipt Date:       September 11, 2001



This Request for Applications (RFA) is to solicit applications that 
address the basic biology of adult stem cells in aging.  Research to 
elucidate the changes that take place in stem cells and their 
environment with normal age and age-related disease will be crucial to 
understanding how and why tissues, organs and organisms senesce and to 
eventual development of stem cell–based therapies for the aged.  
Projects are encouraged that significantly advance research to identify 
and characterize adult stem cells as a function of aging, characterize 
the tissue environment and the interaction of adult stem cells with 
that environment during aging, separate, monitor and control adult stem 
cells from and in aging tissue, and develop or use disease models to 
understand the biology of adult stem cells in disease states common to 
aged individuals.  Applications are solicited for research projects 
that focus on various aging tissues or physiological systems, including 
cardiovascular, musculoskeletal, immune, urogenital, endocrine and 
nervous systems.  


The Public Health Service (PHS) is committed to achieving the health 
promotion and disease prevention objectives of "Healthy People 2010," a 
PHS-led national activity for setting priority areas.  This Request for 
Applications (RFA), Stem Cells in Aging, is related to one or more of 
the priority areas.  Potential applicants may obtain a copy of "Healthy 
People 2010" at 


Applications may be submitted by domestic and foreign for-profit and 
non-profit organizations, public and private, such as universities, 
colleges, hospitals, laboratories, units of state and local 
governments, and eligible agencies of the Federal government. 
Racial/ethnic minority individuals, women, and persons with 
disabilities are encouraged to apply as principal investigators.


This RFA will use the National Institutes of Health (NIH) research 
project grant (R01) award mechanism.  Only new (Type 1) applications 
will be accepted for this initiative.   Responsibility for the 
planning, direction and execution of the proposed project will be 
solely that of the applicant.  The total project period for an 
application submitted in response to the present RFA may not exceed 
five years.  

This RFA is a one-time solicitation.  Future unsolicited competing 
continuation applications will compete with all investigator-initiated 
applications and be reviewed according to the customary peer review 
procedures.  The earliest anticipated award date is April 1, 2002  

Specific application instructions have been modified to reflect 
"MODULAR GRANT" and "JUST-IN-TIME" streamlining efforts being examined 
by the NIH. Complete and detailed instructions and information on 
Modular Grant applications can be found at:


The NIA has set aside $2 Million for the first year of support for 
grants awarded in response to this RFA.  Maximum direct costs requested 
may not exceed $250,000 for the first year.  It is anticipated that 5 
to 7 R01 grants will be supported.  Awards are contingent upon 
availability of funds and the receipt of a sufficient number of 
applications of outstanding scientific and technical merit.  
Applications that are not funded may be revised and resubmitted under 
regular grant procedures for the NIH.

Direct costs will be awarded in modules of $25,000, less any overlap or 
other necessary administrative adjustments. Facilities and 
Administrative costs will be awarded at the negotiated rate.



Stem cells have been derived from both adult and embryonic tissues in 
the mouse.  Mouse embryonic stem cells have the capacity to 
differentiate into all cell types in the body when incorporated into 
the early embryo.  When injected under the skin of the adult mouse, 
they form tumors that contain many differentiated cell types.  Stem 
cells in adult humans may hold the potential to form needed cell types 
in cases where disease or injury have destroyed the original cells.  
However, human embryonic stem cells have only recently been cultured, 
and whether they are analogous to mouse embryonic stem cells in 
potential to form tissues or tumors is still unknown.  Furthermore, 
research on how to control even mouse embryonic stem cells to form 
desired, functional cell types in the desired locations in the body has 
produced limited results.  Successes in this area include the 
triggering of partial differentiation in culture of mouse embryonic 
stem cells to a pre-differentiated state and injection of those cells 
into areas of injury with partial recovery of function.  Similar work 
is continuing on a number of fronts including in spinal cord, cardiac 
tissue and brain tissue.

For many years, it has been clear that putative stem cells (cells that 
can divide to replenish themselves and, as well, produce daughter cells 
that transition into differentiated cell types) exist in a number of 
adult tissues, including bone marrow, muscle, and intestine.  For 
example, the crypt cells of the small intestine form cells that renew 
the lining of the intestine as cells are lost from the villi.  Bone 
marrow cells have been used to replace the hematopoietic and immune 
systems in therapies for diseases.  Overturning long held beliefs, the 
adult brain has now been shown to harbor putative stem cells that can 
generate all neural cell types.  

In recent years, it has become evident that, at least in the mouse, 
adult tissue-derived stem cells, when manipulated or grafted into 
appropriate environments, can form more than the cell types of the 
tissue of origin.  Recent examples include cells from bone marrow that 
can integrate into skeletal myofibers, form oval cells of the liver 
(and hepatocytes upon liver injury), glial cells of the central nervous 
system, and neuron-like cells in the central nervous system.  Selected 
hematopietic stem cells can form cardiomyocytes that replace damaged 
cells in the mouse heart.  Conversely, muscle-derived stem cells can 
replenish the hematopoietic compartment and nervous system stem cells 
can form blood elements and skeletal muscle cells.  

Because mouse adult tissue-derived stem cells appear to be able to 
differentiate more broadly than at first thought, adult stem cells 
present some of the same possibilities for tissue-replacement therapy 
as embryonic stem cells, and some of the same challenges.  In addition, 
if the rules by which comparable human adult stem cells divide and 
differentiate can be understood, there are some advantages for use of 
these cells.  For example, it might be possible to use bone marrow-
derived cells to provide a source of graft material to replace brain 
cells lost through disease or injury.  Indeed, depending on the 
circumstances of the disease, it may be possible to use a patient’s own 
cells for such a therapy, avoiding immune obstacles to grafting in 

There is further promise in understanding the natural role of stem 
cells in tissues of the adult.  Investigation into changes in stem cell 
biology with age may lead to better understanding of the fundamental 
properties of stem cells and the rules by which they function in vivo.  
For example, in humans a number of tissues undergo changes that are 
detrimental to the health and quality of life of aging individuals.  
Muscles, which have a supply of stem cells for addition of muscle mass 
or replacement of muscle fibers, still undergo loss of muscle mass, 
changes in fiber types, and other changes that lead to muscle weakness 
in the elderly.  Bone may become weak and brittle due to changes in 
turnover and remodeling rates.  These changes may be due to an altered 
balance between different bone cell types derived from marrow 
precursors.  Certain areas of the adult brain retain the capacity to 
generate new neurons and glia, yet neuronal dysfunction and decrement 
in brain function can occur with aging.  It is unclear whether such 
changes could be due in part to diminishing supply of stem cells with 
age, altered potential of stem cells to form the required cell types to 
keep a tissue healthy with age, altered aging tissue environments that 
restrict the growth, migration or differentiation of the resident stem 
cells, or other factors associated with age.  Emerging findings suggest 
that tissue stem cells can be coaxed into forming new differentiated 
cells of an organ through environmental manipulations as, for example, 
in enhanced numbers of new hippocampal neurons in adult mice.  

Finally, investigation into the changing properties of adult stem cells 
with age is likely to provide clues to aging itself.  It is possible 
that resident tissue stem cells are susceptible to damage mechanisms 
thought to cause senescence at the cell and tissue levels.  Changes in 
the supply and potential of adult stem cells for replacement of cells 
in the course of normal tissue turnover may be fundamental to the aging 
of the organism.  Thus, not only is investigation of stem cell biology 
in the aging environment crucial to understanding of diseases of aging, 
to development of therapies that allow better quality of life for aging 
individuals, for understanding normal cell turnover in tissues, and for 
future possible replacement of diseased or damaged tissue in the 
elderly, but such investigations may also be pivotal in the study of 
how and why organisms senesce.

Objectives and Scope

This RFA is intended to promote the exploration of changes in adult 
stem cell biology with aging.  Only applications for projects focused 
on understanding stem cell biology during aging, understanding the 
aging environment and its influence on stem cell biology, and 
understanding stem cell biology in disease states common to aged 
individuals, and with a clear relationship to aging as a major 
emphasis, will be accepted for review.  Research projects that focus on 
various aging cells, tissues or physiological systems, including 
cardiovascular, musculoskeletal, immune, urogenital, endocrine and 
nervous systems are of interest, as are studies that use animal models 
or adult human tissue.  Because of the focus of this RFA on basic 
biology of aging stem cells, clinical studies in humans are outside the 
scope of this RFA, as are studies on human embryonic stem cells.  
However, under certain circumstances, projects that involve embryonic 
stem cells from animal models to explore aging stem cells and the aging 
environment may be appropriate.  Applicants are encouraged to discuss 
such projects with NIA program staff before submission.  The following 
areas are of special interest but are examples only, and are not 

o  Investigation of the numbers and types of stem cells resident in 
tissues of the adult and how those populations of stem cells change 
during aging.

o  Characterization of the natural potential for growth, self-renewal, 
migration and differentiation of adult stem cells and their progeny in 
vivo as a function of aging.

o  Manipulation and control of the potential for growth, self-renewal, 
migration and differentiation in vivo and in vitro for adult stem cells 
and their progeny from aging animals/humans.

o  Investigation of changes in aging tissue environments and the 
effects of those changes on stem cell function and on differentiation 
of stem cell progeny.

o  Methods to identify, separate, isolate and monitor stem cells in 
aging tissues.

o  Investigation of disease models and function of adult stem cells in 
disease states common to aged individuals.

o  Characterization of the ability of transplanted or resident adult 
stem cells or their progeny to integrate with host tissue of different 
ages to produce functional changes or restore impaired tissue function.

o  Characterization of genetic determinants influencing adult stem cell 
function in aging and age-related disorders.

o  Investigation of the interrelationship between stem cells and 
fundamental processes that determine the rate at which organisms age.

Applicants are encouraged to talk directly to program staff about 
research allowed under this RFA prior to formulating the application.  

Sharing of Research Resources

Restricted availability of unique research resources, upon which 
further studies are dependent, can impede the advancement of research. 
The NIH is interested in ensuring that the research resources developed 
through grants become readily available to the broader research 
community in a timely manner for further research, development, and 
application, in the expectation that this will lead to products and 
knowledge of benefit to the public health.  It is expected that 
resources to be shared will include, among others, cell lines, mutant 
animals, germplasm, and novel reagents and techniques.


Applicants who respond to this RFA must submit a plan: (1) for sharing 
research resources generated through the grant, and (2) addressing how 
they will exercise intellectual property rights, should any be 
generated through this grant, while making such research resources 
available to the broader scientific community.

The sharing of research resources plan and intellectual property plan 
must describe how unique research resources will be made readily 
available for research purposes to qualified individuals within the 
scientific community in accordance with the NIH Grants Policy Statement and the Principles and 
Guidelines for Recipients of NIH Research Grants and Contracts on 
Obtaining and Disseminating Biomedical Research Resources: Final 
Notice, December 1999 
and  These documents also 
define terms, parties and responsibilities, prescribe the order of 
disposition of rights, prescribe a chronology of reporting 
requirements, and delineate the basis for and extent of government 
actions to retain rights.  Patent rights clauses may be found at 37 CFR 
Part 401.14 and are accessible from the Interagency Edison web page,

Applicants are encouraged to discuss the plans with their Institutional 
Official and office for technology transfer prior to submission of the 
application.  The applicant organization signature on the application 
indicates the agreement of the organization with the plan in the 

Annual Grantee Meeting

It is the intent of the NIA to provide support for stem cell research 
through grant support and through promoting collaboration and 
information sharing between investigators on projects of interest to 
the NIA.   Principal Investigators (PI) on grants resulting from this 
RFA must participate in annual workshops convened by the NIA for 
updates and exchange of information related to the projects between 
investigators and with NIA staff.  In the event the PI is unable to 
attend, a mutually acceptable designee may be agreed upon by the 
grantee and NIA staff to participate.  Travel to this annual workshop, 
expected to be in Bethesda, MD should be included in the budget request 
in the application.


It is the policy of the NIH that women and members of minority groups 
and their sub-populations must be included in all NIH-supported 
biomedical and behavioral research projects involving human subjects, 
unless a clear and compelling rationale and justification are provided 
indicating that inclusion is inappropriate with respect to the health 
of the subjects or the purpose of the research.  This policy results 
from the NIH Revitalization Act of 1993 (Section 492B of Public Law 

All investigators proposing research involving human subjects should 
read the UPDATED "NIH Guidelines for Inclusion of Women and Minorities 
as Subjects in Clinical Research," published in the NIH Guide for 
Grants and Contracts on August 2, 2000 
(, a 
complete copy of the updated Guidelines are available at  
The revisions relate to NIH defined Phase III clinical trials and 
require: a) all applications or proposals and/or protocols to provide a 
description of plans to conduct analyses, as appropriate, to address 
differences by sex/gender and/or racial/ethnic groups, including 
subgroups if applicable, and b) all investigators to report accrual, 
and to conduct and report analyses, as appropriate, by sex/gender 
and/or racial/ethnic group differences.

In addition, applicants should pay particular attention to inclusion of 
appropriate information as instructed for the PHS 398 form in any 
application involving human subjects.  


All applications and proposals for NIH funding must be self-contained 
within specified page limitations.  Unless otherwise specified in an 
NIH solicitation, internet addresses (URLs) should not be used to 
provide information necessary to the review because reviewers are under 
no obligation to view the Internet sites.  Reviewers are cautioned that 
their anonymity may be compromised when they directly access an 
Internet site.


Prospective applicants are asked to submit a letter of intent that 
includes a descriptive title of the proposed research, the name, 
address, and telephone number of the Principal Investigator, the 
identities of other key personnel and participating institutions, and 
the number and title of the RFA in response to which the application 
may be submitted. Although a letter of intent is not required, is not 
binding, and does not enter into the review of a subsequent 
application, the information that it contains allows IC staff to 
estimate the potential review workload and avoid conflict of interest 
in the review.

The letter of intent is to be sent to the program staff listed under 
INQUIRIES by the letter of intent receipt date listed in the heading of 
this RFA.


The research grant application form PHS 398 (rev. 4/98) is to be used 
in applying for these grants, with the modifications noted below.  
These forms are available at most institutional offices of sponsored 
research, from the Division of Extramural Outreach and Information 
Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 
7910, Bethesda, MD 20892-7910, telephone 301/710-0267, email:, and on the internet at:

The RFA label available in the PHS 398 (rev. 4/98) application form 
must be affixed to the bottom of the face page of the application.  
Type the RFA number on the label.  Failure to use this label could 
result in delayed processing of the application such that it may not 
reach the review committee in time for review.  In addition, the RFA 
title and number must be typed on line 2 of the face page of the 
application form and the YES box must be marked.

The sample RFA label available at: has been 
modified to allow for this change.  Please note that this sample label 
is in pdf format.

Applications should be complete at the time of submission.  The 
Scientific Review Office, NIA, will determine whether late materials 
will be accepted.  If late materials are accepted, they will be limited 
to three typed pages and the Scientific Review Administrator in charge 
of the review must authorize submission.

The modular grant concept establishes specific modules in which direct 
costs may be requested as well as a maximum level for requested 
budgets. Only limited budgetary information is required under this 
approach. The just-in-time concept allows applicants to submit certain 
information only when there is a possibility for an award. It is 
anticipated that these changes will reduce the administrative burden 
for the applicants, reviewers and Institute staff. The research grant 
application form PHS 398 (rev. 4/98) is to be used in applying for 
these grants, with the modifications noted below.


Modular Grant applications will request direct costs in $25,000 
modules. The total direct costs must be requested in accordance with 
the program guidelines and the modifications made to the standard PHS 
398 application instructions described below:

PHS 398

o  FACE PAGE: Items 7a and 7b should be completed, indicating Direct 
Costs (in $25,000 increments up to $250,000) and Total Costs [Modular 
Total Direct plus Facilities and Administrative (F&A) costs] for the 
initial budget period.  Items 8a and 8b should be completed indicating 
the Direct and Total Costs for the entire proposed period of support.

Page 4 of the PHS 398.  It is not required and will not be accepted 
with the application.

the categorical budget table on Form Page 5 of the PHS 398.  It is not 
required and will not be accepted with the application.

o  NARRATIVE BUDGET JUSTIFICATION - Prepare a Modular Grant Budget 
Narrative page. (See for sample 
pages.)  At the top of the page, enter the total direct costs requested 
for each year. This is not a Form page.

o  Under Personnel, list all project personnel, including their names, 
percent of effort, and roles on the project. No individual salary 
information should be provided. However, the applicant should use the 
NIH appropriation language salary cap and the NIH policy for graduate 
student compensation in developing the budget request.

For Consortium/Contractual costs, provide an estimate of total costs 
(direct plus facilities and administrative) for each year, each rounded 
to the nearest $1,000.  List the individuals/organizations with whom 
consortium or contractual arrangements have been made, the percent 
effort of all personnel, and the role on the project.  Indicate whether 
the collaborating institution is foreign or domestic.  The total cost 
for a consortium/ contractual arrangement is included in the overall 
requested modular direct cost amount. Include the Letter of Intent to 
establish a consortium.

Provide an additional narrative budget justification for any variation 
in the number of modules requested.

o  BIOGRAPHICAL SKETCH - The Biographical Sketch provides information 
used by reviewers in the assessment of each individual"s qualifications 
for a specific role in the proposed project, as well as to evaluate the 
overall qualifications of the research team.  A biographical sketch is 
required for all key personnel, following the instructions below. No 
more than three pages may be used for each person.  A sample 
biographical sketch may be viewed at:

- Complete the educational block at the top of the form page,
- List position(s) and any honors,
- Provide information, including overall goals and responsibilities, on 
research projects ongoing or completed during the last three years,
- List selected peer-reviewed publications, with full citations.

o  CHECKLIST - This page should be completed and submitted with the 
application.  If the F&A rate agreement has been established, indicate 
the type of agreement and the date. All appropriate exclusions must be 
applied in the calculation of the F&A costs for the initial budget 
period and all future budget years.

o  The applicant should provide the name and phone number of the 
individual to contact concerning fiscal and administrative issues if 
additional information is necessary following the initial review.  

Submit a signed, typewritten original of the application and three 
signed, photocopies, in one package to:

BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (for express/courier service)

At the time of submission, send two additional copies of the 
application to:

Mary Nekola, Ph.D.
Chief, Scientific Review
Scientific Review Office
National Institute on Aging
7201 Wisconsin Avenue, Room 2C212
Bethesda, MD  20892-9205

It is important to send these copies at the same time as the original 
and three copies are sent to the Center for Scientific Review. These 
copies are used to identify conflicts and to help ensure the 
appropriate and timely review of the application.

Applications must be received by the application receipt date listed in 
the heading of this RFA.  If an application is received after that 
date, it will be returned to the applicant without review.

The Center for Scientific Review (CSR) will not accept any application 
in response to this RFA that is essentially the same as one currently 
pending initial review, unless the applicant withdraws the pending 
application.  The CSR will not accept any application that is 
essentially the same as one already reviewed.  This does not preclude 
the submission of substantial revisions of applications already 
reviewed, but such applications must include an introduction addressing 
the previous critique.


Upon receipt, applications will be reviewed for completeness by CSR and 
responsiveness by NIA. Incomplete applications will be returned to the 
applicant. If the application is not responsive to the RFA, CSR staff 
may contact the applicant to determine whether to return the 
application to the applicant or submit it for review in competition 
with unsolicited applications at the next review cycle.

Applications that are complete and responsive to the RFA will be 
evaluated for scientific and technical merit by an appropriate peer 
review group convened by NIA in accordance with the review criteria 
stated below. As part of the initial merit review, a process may be 
used by the initial review group in which applications receive a 
written critique and undergo a process in which only those applications 
deemed to have the highest scientific merit, generally the top half of 
the applications under review, will be discussed, assigned a priority 
score, and receive a second level review by the National Advisory 
Council on Aging.

Review Criteria

The goals of NIH-supported research are to advance our understanding of 
biological systems, improve the control of disease, and enhance health.  
In the written comments reviewers will be asked to discuss the 
following aspects of the application in order to judge the likelihood 
that the proposed research will have a substantial impact on the 
pursuit of these goals.  Each of these criteria will be addressed and 
considered in assigning the overall score, weighting them as 
appropriate for each application.  Note that the application does not 
need to be strong in all categories to be judged likely to have major 
scientific impact and thus deserve a high priority score.  For example, 
an investigator may propose to carry out important work that by its 
nature is not innovative but is essential to move a field forward.

1.  Significance:  Does this study address an important problem?  If 
the aims of the application are achieved, how will scientific knowledge 
be advanced?  What will be the effect of these studies on the concepts 
or methods that drive this field?

2.  Approach:  Are the conceptual framework, design, methods, and 
analyses adequately developed, well-integrated, and appropriate to the 
aims of the project?  Does the applicant acknowledge potential problem 
areas and consider alternative tactics?

3.  Innovation:  Does the project employ novel concepts, approaches or 
method? Are the aims original and innovative?  Does the project 
challenge existing paradigms or develop new methodologies or 

4.  Investigator:  Is the investigator appropriately trained and well 
suited to carry out this work?  Is the work proposed appropriate to the 
experience level of the principal investigator and other researchers 
(if any)?

5.  Environment:  Does the scientific environment in which the work 
will be done contribute to the probability of success?  Do the proposed 
experiments take advantage of unique features of the scientific 
environment or employ useful collaborative arrangements? Is there 
evidence of institutional support?

In addition to the above criteria, in accordance with NIH policy, all 
applications will also be reviewed with respect to the following:

o The adequacy of plans to include both genders, minorities and their 
subgroups as appropriate for the scientific goals of the research. 
Plans for the recruitment and retention of subjects will also be 

o The adequacy of the proposed protection for humans, animals or the 
environment, to the extent they may be adversely affected by the 
project proposed in the application.

Reviewers will comment, as appropriate, on the adequacy and feasibility 
of the sharing of research resources plan and the intellectual property 
plan.  Comments on the plans and any concerns will be presented in an 
administrative note in the Summary Statement.   NIH program staff will 
consider the adequacy of the plans in determining whether to recommend 
an application for award.  The approved plans will become a condition 
of the grant award and Progress Reports must contain information on 
activities for the sharing of research resources and intellectual 

The personnel category will be reviewed for appropriate staffing based 
on the requested percent effort.  The direct costs budget request will 
be reviewed for consistency with the proposed methods and specific 
aims.  Any budgetary adjustments recommended by the reviewers will be 
in $25,000 modules.  The duration of support will be reviewed to 
determine if it is appropriate to ensure successful completion of the 
requested scope of the project.


Letter of Intent Receipt Date:  August 14, 2001
Application Receipt Date:       September 11, 2001
Date of Initial Review:         December, 2001
Review by Advisory Council:     February, 2002
Anticipated Award Date:         April 1, 2002


The following will be considered in making funding decisions:  
o Scientific merit as determined by peer review
o Availability of funds
o Programmatic priorities
o Adequacy of plan for sharing of research resources and plan for 
intellectual property


Inquiries concerning this RFA are encouraged.  Additional information, 
including sample budget narratives and biographical sketch, may be 
found at this site:  The 
opportunity to clarify any issues or questions from potential 
applicants is welcome.

Direct inquiries regarding programmatic issues to:

Jill L. Carrington, Ph.D.
Chief, Systems Branch
Biology of Aging Program
National Institute on Aging
7201 Wisconsin Avenue, Suite 2C231 MSC 9205
Bethesda, MD  20892-9205
Telephone:  (301) 496-6402
FAX:  (301) 402-0010

Bradley C. Wise, Ph.D.
Program Director, Fundamental Neuroscience
Neuroscience and Neuropsychology of Aging Program
National Institute on Aging
7201 Wisconsin Avenue, Suite 3C307 MSC 9205
Bethesda, MD   20892-9205
Telephone: (301) 496-9350
FAX: (301)  496-1494

Direct inquiries regarding fiscal matters to:

Ms Linda Whipp
Grants and Contracts Management Office
National Institute on Aging
7201 Wisconsin Avenue, Suite 2N212, MSC 9205
Bethesda, MD  20892-9205
Telephone:  (301) 496-1472
FAX:  (301) 402-3672


This program is described in the Catalog of Federal Domestic Assistance 
No. 93.866.  Awards are made under authorization of Sections 301 and 
405 of the Public Health Service Act as amended (42 USC 241 and 284) 
and administered under NIH grants policies and Federal Regulations 42 
CFR 52 and 45 CFR Parts 74 and 92.  This program is not subject to the 
intergovernmental review requirements of Executive Order 12372 or 
Health Systems Agency review

The PHS strongly encourages all grant and contract recipients to 
provide a smoke-free workplace and promote the non-use of all tobacco 
products.  In addition, Public Law 103-227, the Pro-Children Act of 
1994, prohibits smoking in certain facilities (or in some cases, any 
portion of a facility) in which regular or routine education, library, 
day care, health care or early childhood development services are 
provided to children.  This is consistent with the PHS mission to 
protect and advance the physical and mental health of the American 

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