Cleveland Clinic's recent declarations that it wants to benefit the community have been called by detractors a savvy business strategy and by advocates, altruistic. The health system has put into place new initiatives--from helping residents cope with a statewide ban on smoking in workplaces, bars, and restaurants to taking out a full-page advertisement about community benefits--at a time when questions have been raised about whether it provides enough charity care to earn its tax-exempt status.