With Allegheny County on the verge of prohibiting smoking in restaurants, taverns and other places the public frequents, many are still trying to figure out how it will apply to their properties.

Health care facilities might face the greatest challenge because of an amendment accepted shortly before County Council approved the ban Tuesday night.

Darrell Sapp, Post-Gazette Esther Rubin, of Oakland, smokes her cigarette along Locust Street while her husband waits for a doctor's appointment. She said of the smoking ban: "In the casket, when I die, I want a little pocket so I can bring some cigarettes with me." Click photo for larger image.

Introduced by Councilman William Robinson, D-Hill District, the clause, which may be the first of its kind anywhere, bans smoking on any property owned wholly or in part by a health care facility.

Other categories of buildings would be smoke-free indoors and within 15 feet of their entrances.

In the case of hospitals, Mr. Robinson said, "15 feet was insufficient, [and] we needed to say that health care providers need to carry the majority of the burden."

Many of the ban's proponents were from the medical community, he noted, and their arguments about the dangers of secondhand smoke were powerful. So health care providers must set a higher standard to avoid hypocrisy, explained Mr. Robinson, who doesn't smoke.

"It's sometime embarrassing and awkward to have employees, visitors and vendors standing outside of cancer facilities, knowing full well what's going on inside, and be puffing away," he said. "I've seen this myself and it's always disturbed me personally that this goes on."

But prohibiting smoking on hospital grounds could invite complications.

While her sister had surgery yesterday at UPMC Presbyterian, Theresa Matthews several times took an elevator to the hospital's parking garage floor, walked outside to the designated smoking area and puffed on her Marlboro Lights.

That's what she does when she's nervous.

And being at a hospital -- especially when her sister sits upstairs battling liver cancer -- does just that.

"A hospital, it's a little different," said Ms. Matthews, of Versailles. "When you're here just sitting and waiting, sometimes four or eight hours, yeah, you can drink a coffee, but what else are you going to do? "I think there should be a place for everybody to go, to relieve some of the tension. I don't see anything wrong with it if it's done outdoors."

If the antismoking ordinance takes effect, the hospital territory where Ms. Matthews stood yesterday will be off-limits to smoking. Currently, both UPMC Presbyterian and neighboring Children's Hospital have abutting outdoor alcoves designated for smokers. The measure could create confusion, particularly in Oakland where UPMC has a significant presence. The ordinance would forbid smoking even on parking lots that it owns.

But some nearby buildings, including the biomedical science towers, Falk Clinic and the Graduate School of Public Health, are owned by the University of Pittsburgh. It would seem the 15-foot rule, rather than the property rule, would apply to them.

"We haven't explored the new law yet so we're not going to be commenting on what impact that would have," Pitt spokesman John Fedele said.

Mr. Robinson anticipates "some serious discussion and dispute" while health care facilities work through the new rules.

"I don't think any of my colleagues believed we would cover all bases and all situations," he said. "Some of these issues will probably end up in a court of law."

So far, hospitals plan to implement the new rules.

"Currently we do have in place a policy that prohibits smoking in any UPMC facility," said spokesman Frank Raczkiewicz. "UPMC fully supports and intends to comply with this new smoking ban."

Children's Hospital already planned to make the campus it is constructing in Lawrenceville smoke-free, said spokesman Marc Lukasiak.

Allegheny General Hospital currently has two outdoor designated smoking areas, one near a side-street entrance and the other in a courtyard off the cafeteria, said spokesman Dan Laurent. "It would seem that the sidewalk will be the only option if this moves forward," he said. "It's certainly going to pose a challenge, especially in enforcement. You can post as many signs as you want, but you're going to find offenders."

Conemaugh Health System in Johnstown implemented property-wide smoke-free policies in November, said spokeswoman Amy Bradley.

"It's been hard for people, but the [hospital] board and leadership felt strongly we wanted to be a smoke-free campus, and we are," she said.

Allegheny County's ordinance takes effect 90 days after its passage.

Smoking would not be allowed "in any enclosed area to which the general public is routinely permitted." Also, smoking would not be allowed within 15 feet of entrances to such sites. Workplace smoking would be forbidden unless a binding agreement exists between labor and management addressing the issue.

According to Mr. Robinson, Pittsburgh International Airport, which belongs to the airport authority that was authorized by the county, would be subject to the ordinance.

Smoking now is limited to bars at the airport. Even before County Council's action, the airport authority had been reviewing the policy, Executive Director Kent George said.

Mr. George said the authority would take County Council's desires into account as part of the review. But he added he believes that airport eateries are different than bars and restaurants elsewhere in the county because nearly all at the airport are in a secure area with no outside access.

Council prohibited smoking in casinos, but the state Senate yesterday adopted an amendment that would override local ordinances to allow tobacco use in gaming establishments.

Specialty tobacco establishments and cigar bars they operate would be exempt from the ban, and lodging establishments can designate up to 25 percent of their rooms for smoking.

Charities and nonprofits can apply for up to 12 waivers annually for smoking at fund-raisers that children may not attend.

For the first six months of the ban's implementation, individuals and property owners will be warned for the first violation and each will be fined $250 for subsequent violations. After the grace period, fines will be levied for first and subsequent violations. With the third violation, businesses and other establishments could face license suspension.