Release Date: September 4, 1998

RFA:  NR-99-001


National Institute of Nursing Research

Letter of Intent Receipt Date: December 14, 1998
Application Receipt Date: January 14, 1999


The National Institute of Nursing Research (NINR) invites applications for
research center core grants in key clinical and basic areas of nursing research
that establish a scientific basis for the care of individuals across the life
span. The Nursing Research Center Core grants (NRCC) will provide the
infrastructure to centralize resources and facilities to support an active center
of excellence in a specific area of inquiry that has a strong base of research
funding.  By developing infrastructure components, a number of established and
independently funded investigators and their teams will have the opportunity to
enhance their collective productivity to a greater degree than would be possible
from each of their separately funded projects.


The Public Health Service (PHS) is committed to achieving the health promotion
and disease prevention objectives of "Healthy People 2000," a PHS-led national
activity for setting priority areas.  This Request for Applications (RFA),
Nursing Research Center Core Grants, is related to the priority areas of maternal
and child health, acute and chronic disabling conditions, HIV infections and
sexually transmitted diseases, health promotion and disease prevention topics,
and women's health issues.  Potential applicants may obtain a copy of "Healthy
People 2000" at


Applications may be submitted by domestic for-profit and non-profit
organizations, public and private, such as universities, colleges, hospitals,
laboratories, units of State or local governments, and eligible agencies of the
Federal Government. Foreign institutions are not eligible for the center program
grants.  Racial/ethnic minority individuals, women, and persons with disabilities
are encouraged to apply as Principal Investigators.
Institutions eligible for the Nursing Research Center Core Grants are those at
which there are at least three projects funded by Department of Health and Human
Services (DHHS)  research support grants from selected mechanisms (specifically,
R01, R15, R18, R29, P01, P20, P50, U01) or comparable peer reviewed research
projects (including those funded by State governments and private foundations)
related to the scientific area of nursing inquiry.  Each of these projects must
have at least one year of committed support remaining at the time of the
application receipt date.  At least two of the projects must be in the college
or school of nursing or department of nursing.  A larger number of NIH awards in
the scientific area of inquiry for the active center of excellence would
strengthen an application. Institutions with centers grants funded from previous
NINR RFAs are eligible.

Only one NRCC application will be accepted from any single applicant
organization.  Joint applications will not be accepted from investigators at
neighboring, independent institutions, but subcontracts are allowed if their
usage enhances the development of the scientific area of inquiry and stays within
the dollar limits of the RFA.


This RFA will use the National Institutes of Health (NIH) research center core
grant mechanism (P30).  The purpose of this mechanism is to support shared
resources and facilities for a specific area of scientific inquiry by a number
of investigators who provide an interdisciplinary approach to a joint research
effort or who focus on a common research problem. The centers grant is funded
independently from the currently funded projects but is integrated with them to
provide support.  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 this RFA may not exceed five
years.  This RFA is a one-time solicitation.  NINR plans to reissue this
announcement annually subject to availability of funds.  Support for NRCC
awardees may be renewed in competing continuation applications pending future
NRCC RFAs.  The anticipated award date is July 1999.


The NINR intends to commit approximately $2,100,000 in FY 1999 to fund seven to
nine new and/or competitive continuation grants in response to this RFA.

An applicant may request a project period of three to five years and a budget for
total costs (direct and indirect) of up to $300,000 for the first year.  Centers
in early stages of development might find it easier to justify lesser amounts
(such as $150,000 per year) in the developmental period.  Cost-of-living or
inflationary increases in subsequent budget years for recurring costs such as
personnel and supplies may not exceed three percent escalation per year.

Although the financial plans of the NINR provide support for this program, awards
pursuant to this RFA are contingent upon the availability of funds and the
receipt of a sufficient number of applications of outstanding scientific and
technical merit.


In FY 1994, the National Institute of Nursing Research implemented the research
center core grant (P30) mechanism.  This program has served as an important
mechanism for building and maintaining intellectual and physical resources that
serve as the infrastructure for synergism among researchers in a specific area
of scientific inquiry.  Centers promote programs of research related to NINR
program areas, foster interdisciplinary research, and provide an important
mechanism to support the delivery of research results into the clinical practice

The success of the NRCC is greater when scientific and professional personnel
representing a variety of disciplines are willing to relate to and collaborate
with each other in order to facilitate the development of new knowledge.  The
promotion of interdisciplinary research is a valued component of the centers

The core center program will provide funding for institutions at various
developmental stages of nursing research capability.  The field of nursing
research has many institutions with nursing programs in earlier stages of
establishing research programs.  At the same time there are also institutions
with well-developed nursing research programs and those that have new areas
identified for future development.  Programs at these different developmental
stages may require different forms of core support.

Applicants should select the scientific area of inquiry based on a conceptually
sound integration of currently funded projects.  The link to nursing practice
issues within the center should be explicit.  Applications should contain
innovative ideas and sound methodology in a specific aspect of nursing research
consistent with the NINR mission.  The following NINR research program categories
describe the broad areas of interest; proposed scientific areas for this RFA are
not limited to the following concepts, however.

o  Research in chronic illness and long term care, including care of individuals
with arthritis, diabetes, and urinary incontinence; and long-term care and

o  Research in health promotion and risk behaviors, including studies of women's
health; developmental transitions, such as adolescence and menopause;
environmental health; and health and behavior research, such as studies of
exercise, nutrition, and smoking cessation.

o  Research in reproductive and infant health, including prevention of premature
labor, reduction of health-risk factors during pregnancy,  normal physiologic
processes of labor and delivery, delivery of prenatal care, care of neonates,
infant growth and development, and fertility issues.

o  Research in cardiopulmonary health and critical care, including prevention and
care of individuals with cardiac or respiratory conditions. This area also
includes research in critical care, trauma, wound healing, and organ

o  Research in immune responses and oncology, including care of individuals
experiencing symptoms primarily associated with cancer and AIDS, such as fatigue,
nausea and vomiting, and cachexia. Prevention research on specific risk factors
is also included. 

o  Research in neurofunction and sensory conditions, including pain management,
sleep disorders, and symptom management for persons with cognitive impairment or
chronic neurological conditions. This area also includes research on patient care
in acute care settings. 

Applicants from institutions that have a General Clinical Research Center (GCRC)
funded by the NIH National Center for Research Resources may wish to identify the
GCRC as a resource.  Details of the interactions of the NRCC staff with the GCRC
staff and research personnel may be provided in a statement describing the
collaborative linkages being developed.  A letter of agreement from the GCRC
Program Director must be included with the application.


A nursing research center must be an identifiable organizational unit either
within a college or school of nursing or within a department of nursing in a
university-affiliated medical center or hospital or other similar entity. 

A Nursing Research Center Core Grant benefits from an interdisciplinary approach.
When multiple organizations within an institution are represented in the
application, clear lines of authority and sanction by the appropriate
institutional officials must be specified.

Funding is intended to support shared resources and facilities (core units) that
will enhance and extend the effectiveness of research at the applicant


A core is a shared central facility, such as a laboratory, service, or other
resource.  Each core is directed by an investigator with substantial expertise
related to the core.  Core facilities may be proposed which will enhance
productivity or in other ways benefit a group of investigators to accomplish
their stated goals.  An important consideration is the degree to which core
facilities will be utilized by and benefit individual ongoing-funded projects and
center investigators and will assist in the development of the scientific area
of inquiry. Each center must have a minimum of three core units.

Administrative Core

An Administrative core is mandatory for all NRCCs.  The Administrative Core
should manage the overall activities of the Center.  This should include the

1.  A specified Director and Associate Director;
2.  A description of the administrative structure;
3.  A general description of overall facilities and institutional commitment;
4.  Separate budget pages detailing the various administrative expenses and the
pilot and/or feasibility studies, if included in the administrative core.

Each applicant institution will name an NRCC Director who will be the key figure
in the administration and management of the NRCC grant.  The Director will be
responsible for the organization and operation of the NRCC.  The Director should
be experienced in conducting research and have demonstrated ability to
coordinate, integrate, and provide guidance in the establishment of new programs
in the scientific area of inquiry.  The Director must make an appropriate time
commitment.  An Associate Director must be named who will be involved in the
administrative and scientific efforts of the Center.

It is expected that the NRCC administrative structure will accomplish the
1.  coordinate and integrate the NRCC components and activities;
2.  review the utilization of funds, including funds for pilot and feasibility
3.  advise the NRCC Director on the activities of the Center's cores;

Other Core Units

The NINR, through the NRCC mechanism, may support cores that seem likely to
result in scientific accomplishments.  It is important to note that support is
not allowed for cores that only replace or centralize resources supported on
individual project grants. The other core units may be a combination of research
support, research development, and research dissemination. Various types of other
core units are acceptable. Examples of possible cores that may be proposed

Statistical Support Core: Provides centralized research equipment and services
as well as data management functions such as patient registry, patient
coordination, evaluation, clinical and laboratory data gathering, biometry or
statistical data coordination. Assistance from computer experts,
biostatisticians, and other individuals who can assist or collaborate with the
participating investigators in conducting laboratory or applied clinical research
relevant to clinical practice and patient outcomes issues may also be desirable.

Regional Centers: Provides a focal point that can increase the pool of nursing
researchers and resources and allow them to be more efficiently managed in a
specified area of research. Regional activities may be an effective method of
increasing involvement of minority investigators and enhancing research on
minority health issues.

Biobehavioral or biomedical core: Provides a centralized laboratory, allowing the
access to large scale equipment, specialized personnel, and other items necessary
to conduct basic or applied research.

Dissemination Core: Supports dissemination of research or other results in the
selected topical area into clinical practice by facilitating the research
training of staff in new skills and techniques as well as enhancing the exchange
and dissemination of information critical to the scientific area of inquiry both
within the NRCC and within the broader scientific community.

Applications are not limited to these examples, additional research cores are
welcomed. All cores must be well justified, conceptually linked to the scientific
area of inquiry, clearly demonstrate how the shared resources will enable
investigators to conduct their independently funded research projects more
efficiently and/or more effectively, and remain within the $300,000 total costs
of the NRCC award.

In a Nursing Research Center Core Grant application, it is not sufficient for the
applicant merely to identify such centralized resources.  Rather, it must be
demonstrated exactly how each core would augment or enhance the present
capabilities of the investigators and make possible new activities.  In addition,
after an award is made, the NINR will require documentation in annual progress
reports and in renewal applications that sharing of resources has been achieved.


Pilot and/or feasibility studies are a mandatory component of the NRCC
application.  These are intended to enable eligible investigators to explore the
feasibility of a concept within the scientific area of inquiry and to amass
sufficient data to pursue it through other funding mechanisms. They may be
included in any proposed core, including the Administrative Core.  The monies
provide modest research support for a limited time (one (1) year or two (2) years
maximum with clear justification for the time length). Eligible investigators

1.  An established investigator in the scientific area of inquiry with a proposal
for testing the feasibility of a new or innovative idea that is conceptually
related but represents a clear and distinct departure from the investigator's
ongoing research interest;

2.  An established, supported investigator with no previous work in the
scientific area of inquiry who is willing to test the applicability of his/her
expertise on a conceptually related problem;

3.  A new investigator who has not been a Principal Investigator in the past, or
who is not currently funded with an NIH research project grant (e.g., R01, P01,

Applications must propose at least three pilot and/or feasibility studies to be
carried out during the first year.  Standard guidelines for IRB approval apply.
The theoretical basis for the pilot and/or feasibility studies must be clearly
explicated for the behavioral, psychosocial, and/or biological strategies being
used.  An interdisciplinary approach should be utilized to promote the
collaboration of nurse scientists with scientists of other disciplines.  Each
pilot and/or feasibility study is limited to fifteen pages of description for the
Research Plan, Sections a through d, and should delineate the question being
asked, detail the procedures to be followed, and discuss how the data will be
analyzed. Subsequent pilot and/or feasibility studies (a minimum of two (2)
ongoing each year) will be developed during the course of the award. A
description of how the pilot and/or feasibility studies will be reviewed and
selected must be provided.  Results of each pilot and/or feasibility study must
be in the Center's annual progress reports to the NINR along with the plan used
to solicit the new pilot and/or feasibility studies.

For pilot and/or feasibility studies involving clinical research, NIH requires
applicants to give special attention to the inclusion of women, minorities and
children in study populations.  Study populations must be described in the
research design and methods section for each pilot and/or feasibility study.  If
women, minorities or children are not included in the study populations for the
clinical studies, a specific justification for each of these exclusions must be
provided.  Applications without such documentation will not be accepted for
review.  Further information about this policy may be requested from NINR staff. 


While the final administrative structure of the NRCC will, for the most part, be
left to the discretion of the applicant institution, NIH's experience has
demonstrated that the effective development of Center programs requires
interaction among the Director, the core leaders, the Principal Investigators of
research projects using the cores, appropriate institutional administrative
personnel and the staff of the awarding agency. To facilitate communication
between the NRCC staffs and the NINR, the NINR expects that each NRCC application
will include funds for the NRCC Director, Associate Director, and business
official to travel to an annual meeting in Bethesda, Maryland.

An Executive Committee, consisting of the Associate Director and the heads of
each of the cores and the business official, should be established to assist the
Director in making the scientific and administrative decisions relating to the
Center.  In addition to coordination of the NRCC, the Director, with his or her
Executive Committee, will be responsible for allocation of NRCC funds, the
identification and selection of key personnel, and the planning and evaluation
of the NRCC activities.

An external Advisory Committee should be established and composed of scientists
from within the institution and at least two (2) scientists from outside the
institution.  This committee may also be used in evaluating the overall research
programs of the NRCC, the effectiveness of communications within the NRCC, and
any other activities in which problems arise for which  expertise is required or
desirable.  The advisory committee should meet at least once annually.  However,
the nature of its responsibilities may require ad hoc meetings at more frequent
intervals.  A member of the NINR extramural program staff is to be invited to
attend each meeting as an observer.

The NRCC Director must describe the process that he or she will use to review the
pilot and/or feasibility studies for future years of the proposed center.  The
review process may be carried out by the Advisory Committee, by an ad hoc Review
Committee, by a mail review, or by a combination of these methods.  It is
recommended that the NRCC Director utilize at least two (2) scientists with
expertise relevant to the scientific area of inquiry of the NRCC from outside the
institution during the review process.

The complex nature of administrative requirements of the NRCC will necessitate
the assistance of a person with business management expertise.  It is important
that such an official be identified and directly involved with the fiscal aspects
of the NRCC application and grant. An appropriate amount of this individual's
time and effort should be committed for this purpose.  The institutional business
official should be a member of the Executive Committee.  While budget formulation
and planning will undoubtedly begin with the Director in collaboration with the
scientific staff, the business official should be involved in the process and
provide consultation in matters of fiscal administration and evaluate such issues
as equipment on hand versus that requested for the core facilities. The business
official should attend the annual Director's meeting and funds may be requested
in the budget for this purpose.


A plan for evaluating progress toward aims and/or goals of each core and the
overall NRCC is required. This plan should include the specific criteria and
methods that will be used for the evaluation. The plan should specify the types
of evaluation information that will be submitted in the centerĂ¾s annual progress
reports. Annual progress reports of a funded NRCC will be reviewed by NINR staff.


It is the policy of the NIH that women and members of minority groups and their
subpopulations must be included in all NIH-supported biomedical and behavioral
research projects involving human subjects, unless a clear and compelling
rationale and justification is provided 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 103-43).

Investigators proposing research involving human subjects should read the NIH
Guidelines For Inclusion of Women and Minorities as Subjects in Clinical Research
which were published in the Federal Register of March 28, 1994 (FR 59 14508-
14513), and in the NIH Guide for Grants and Contracts, Volume 23, Number 11,
March 18, 1994.

Investigators may obtain copies from these sources or from the program staff or
contact person listed under Inquires section.  Program staff may also provide
additional relevant information concerning the policy.


It is the policy of NIH that children (individuals under the age of 21) must be
included in all human subjects research conducted or supported by the NIH, unless
there are scientific and ethical reasons not to include them.  This policy
applies to all initial (Type 1) applications submitted for receipt dates after
October 1, 1998.

All investigators proposing research involving human subjects should read "NIH
Policy and Guidelines on the Inclusion of Children as Participants in Research
Involving Human Subjects" that was published in the NIH Guide for Grants and
Contracts, March 6, 1998, and is available at the following URL address:


Prospective applicants are asked to submit, by December 14, 1998, 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
this 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 NINR
staff to estimate the potential review workload and to avoid conflict of interest
in the review.

The letter of intent is to be sent to:

Robin L. Gruber, MPS
National Institute of Nursing Research
Building 45, Room 3AN-12
Bethesda, MD  20892-6300
Telephone:  (301) 594-2736 or 6906
FAX:  (301) 480-8260


The research grant application form PHS 398 (rev. 5/95) is to be used to apply
for these grants. These forms are available at most institutional offices of
sponsored research and 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:

Sample tables and additional information on the application format and contents
are outlined in the NRCC application guidelines available upon request from

Page Limitations: Each core is limited to 25 pages and each pilot study is
limited to 15 pages for the Research Plan sections a through d. Lesser numbers
of pages are acceptable.

Budget: A separate budget page, with appropriate justification pages, is required
for each core and pilot study.

The RFA label available in the PHS 398 (rev. 5/95) application form must be
affixed to the bottom of the face page of the application.  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 in line 2 of the face page of the application form and the
YES box must be marked. 

Submit a signed, typewritten original of the application, including the
Checklist, and three signed, photocopies, in one (1) package to:

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

At the time of submission, two additional copies of the application must also be
sent to:

Dr. Mary Stephens-Frazier
Division of Extramural Activities
National Institute of Nursing Research
Building 45, Room 3AN-12 MSC 6300
Bethesda, MD  20892-6300
Telephone:  (301) 594-6906

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 the CSR and 
responsiveness by NINR. Incomplete and/or non-responsive applications will be
returned to the applicant without further consideration.

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
the NINR in accordance with the review criteria stated below.  As part of the
initial merit review, all applications will receive a written critique and may
undergo a process in which only those applications deemed to have the highest
scientific merit, generally the top half of applications under review, will be
discussed, assigned a priority score, and receive a second level review by the
National Advisory Nursing Council.

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

Careful consideration of the information in the SPECIAL REQUIREMENTS section of
the RFA and the following review criteria will be used to evaluate the NRCC grant
(P30) applications: 


1.  Focus and depth of funded investigations that are currently in progress.
2.  Presence of current and emerging collaborations and interactions, with common
research interests, among the investigators within the research base.
3.  Impact that funded investigators have made in their respective fields, as
indicated by publications and other factors.
4.  The qualifications, experience, and commitment of the NRCC investigators
responsible for the individual research projects, and their willingness to
interact with each other.
5.  The appropriateness of the investigators as participants of the center, and
whether their activities warrant core support.


1.  The inclusion of a mandatory Administrative core to manage the overall
activities of the Center.
2.  The appropriateness and relevance of the proposed cores and the modes of
operation, facilities, and potential for contribution to ongoing nursing
3.  Evidence of collaborative and/or interdisciplinary research.
4.  Appropriate justification for each core component. Considerations include the
duplication of existing resources or services and anticipated future use of each


1.  The scientific merit of the research proposed, how well the research fits
into the focus of the overall center grant and the importance of the information
sought to the goals of the NINR.
2.  The feasibility and promise of the proposed methods.
3.  The novelty or originality of the applications.
4.  The training, experience, and research competence of the investigator(s).
5.  The suitability of the facilities for the proposed research, including the
availability of required special resources.
6.  The appropriateness and justification of the requested budget for the
proposed work.
7.  Provisions for the protection of human subjects and the humane care of


1.  The overall scientific merit and the potential of the research program for
making a significant contribution to achieving the goals of the NINR.
2.  The scientific gain from linking the research projects in a center grant,
i.e., the degree of interrelatedness and synergism among the components of the
3.  An interdisciplinary approach.
4.  The qualifications of the Principal Investigator and other key investigators
and the commitment of participating investigators to a common goal and to
5.  The adequacy of the available resources and the quality of the research
6.  The adequacy of the multiple aspects related to the administrative structure
for the center, including the ability of the center director to provide the
scientific and administrative leadership for the project; strategies to promote
scientific planning, interaction, implementation, and evaluation; and
arrangements for the fiscal management of the grant.
7.  The institutional commitment to the center in terms of space, resources,
administrative authority, and other necessary support; the extent to which the
center is recognized as a major element within the organizational structure of
the institution.
8.  The plans for developmental activities, including recruitment and expansion,
insofar as these are justified by the proposed research program.
9.  The plans for outreach and collaboration with other groups doing related
10.  Provisions for the protection of human subjects and the humane care of
 A plan for evaluation of activities of the NRCC.
12.  Appropriateness of the requested budget for the work proposed.
13.  Proposed composition and functions of the external advisory committee
 Proposed process of reviewing pilot/feasibility studies

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,
and children as appropriate for the scientific goals of the research.  Plans for
the recruitment and retention of subjects will also be evaluated.

o  The reasonableness of the proposed budget and duration in relation to the
proposed research.

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.

The initial review group will also examine the provisions for the protection of
human subjects and the safety of the research environment.

Letter of Intent Receipt Date: December 14, 1998
Application Receipt Date: January 14, 1999
Peer Review Date: March 1999
Council Review: May 1999
Earliest Anticipated Start Date: July 1999


Award criteria that will be used to make award decisions include:
o  scientific merit (as determined by peer review)
o  availability of funds
o  programmatic priorities.


Inquiries concerning this RFA are encouraged.  The opportunity to clarify any
issues or questions from potential applicants is welcome.  NRCC application
guidelines are available upon request from NINR staff. 

Direct inquiries regarding programmatic/scientific issues to:

Cara J. Krulewitch, CNM, PhD
Division of Extramural Activities
National Institute of Nursing Research
Building 45, Room 3AN-12 MSC 6300
Bethesda, MD  20892-6300
Telephone:  (301) 594-2542
FAX:  (301) 480-8260

Direct inquiries regarding fiscal matters to:

Jeff Carow
Grants and Contracts Management Office
National Institute of Nursing Research
Building 45, 3AN-12 MSC 6301
Bethesda, MD  20892
Telephone:  (301) 594-6869
FAX:  (301) 480-8260


This program is described in the Catalog of Federal Domestic Assistance No.
93.361 Nursing Research.  Awards will be made under the authority of the Public
Health Service Act, Title IV, Part A (Public Law 78- 410, as amended by Public
Health Law 99-158, 42 USC 241 and 285) and administered under PHS grants policies
and Federal regulations 42 CFR Part 52 and 45 CFR Part 74.  This program is not
subject to intergovernmental review requirements of Executive Order 12372 or
Health Systems Agency review.

The PHS strongly encourages all grant 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 people.

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