The American College Health Association released new guidelines Monday urging colleges and universities to adopt policies barring all tobacco use indoors and outdoors on their campuses.

The recommendations signal a shift for the association, which in its previous position statement, adopted in 2005, urged campus health officials to ban all smoking indoors but still permit it in “designated smoking spaces” outside.

Jim Turner, president of the ACHA and executive director of the University of Virginia’s student health center, said the guidelines reflect policies that are “from a public health standpoint, what we all aspire to have for our campuses.”

He acknowledged the position statement “sets a very, very high bar for some campuses to get to,” but said that the members of the ACHA’s board, executive committee and Alcohol, Tobacco and Other Drugs Coalition considered it “an important statement to be made” about tobacco use on campuses. “We may not achieve our total goal across the country but at least we can provoke a debate and get some movement on our campuses.”

Cynthia Hallett, executive director of Americans for Nonsmokers’ Rights, called the guidelines “excellent” progress and said she hoped campuses would seriously consider adopting them.

As of October 6, Hallett’s group had identified 365 U.S. colleges and universities with policies requiring that all campus spaces, indoors and outdoors, be smokefree. Another 76 institutions have “100 percent smokefree campuses with minor exemptions for remote outdoor areas.”

All 33 public college and university campuses in the state of Arkansas prohibit smoking inside and outside. Despite complaints and protests coming from employees and students, a law enacted last year in Pennsylvania bars smoking indoors and outdoors at all 14 universities in the Pennsylvania State System of Higher Education.

The ACHA’s recommendations go even further. They ban not just the use of cigarettes, cigars and other smoke-producing products but also the use of snuff, chewing tobacco and other smokeless tobacco products. The eventual goal, as described in the position statement, is “becoming or maintaining tobacco-free living and learning environments that support the achievement of personal and academic goals.”

John Nothdurft, a legislative specialist on tobacco at the Heartland Institute, a nonprofit with libertarian and conservative positions, said he is “not surprised by any means” by the ACHA’s recommendations. “You saw this in Pennsylvania, you’ve seen this in other states,” he said. “This is more of a PR stunt than anything else. It’s more nannying going on by organizations trying to win brownie points from special interest groups.”

Nothdurft expressed concern that institutions would adopt policies “without considering all the unintended consequences and questions it creates.” Students, employees and visitors, he said, “will have to go off campus – maybe to an unsafe area, maybe not – just to use a legal product that they should be able to use outdoors without doing harm to others.”

He also criticized the absence of recommendations on how to enforce tobacco-free policies. “It’s hard to enforce a smoking ban and this document offers no suggestions,” he said. “As I see it, all these activities could keep going on” without penalty on campuses that choose to adopt the ACHA’s recommendations.

Turner said he “heard very little resistance” from within the ACHA on adopting the recommendations. “One concern a member had was that our guidelines not violate state or local law but, from a public health standpoint, we all agreed this was needed.”

Turner said that the University of Virginia, his institution and the flagship university in a state that’s had a dominant tobacco industry for centuries, enacted a ban on smoking outside all its medical facilities and research labs that went into place on October 1, having banned smoking indoors years ago.

“I go over to the medical school for meetings and I no longer see people in their scrub suits smoking outside the back entrance there,” he said. “Anecdotally, in my own little world, it’s really had a profound impact.”