Bright Spot: Local Government Smoke-free or Tobacco-free Regulations

Photo by Kristaps Solims on Unsplash


This bright spot was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.

Overview

Detailed Description

Enact local smoke-free regulations to protect people from second-hand smoke exposure, which is a preventable cause of significant illness and death. Educate and involve the public to increase compliance rates.


Expected Outcomes

Decrease tobacco use and second-hand smoke exposure



Cost Details

Historically, most local smoking ordinances have been "self-enforcing" and were successfully implemented with little or no additional resources. However, dedicated funding can support effective education, compliance and cessation. Based on availability of funding, education campaigns may include television, radio, fact sheets, signage, websites, billboards and print ads. The intervention effort can include more extensive cessation services through availability of Nicotine Replacement Therapy. An educational campaign could also include business kits and made use of local programs to educate business groups. A typical campaign runs both before and after the effective date of the law, averaging 4-8 months in duration. At least 1 FTE devoted education and compliance. The volume of calls to the complaint lines will decrease rapidly as the public and businesses became accustomed to the new smoke-free law. Health departments have also expressed the belief that investing more resources in an education campaign earlier on reduced the volume of complaints and prevented greater enforcement problems down the road.

Key Steps for Implementation

  1. Find out where the authority for developing and passing smoke-free air legislation lies in your state and community.
  2. Find out if your state law has a preemption clause. If your state does not have preemption, find out if smoke-free ordinances already exists, and if it should be updated.
  3. Review existing tobacco use regulations.
  4. Access policy options with model language.
  5. Form a committee of managers, staff, nonsmokers, smokers, and ex-smokers.
  6. Designate an enforcement agency.
  7. Write the policy and develop a plan to educate the public on the health effects of smoking.
  8. Publicly announce the upcoming changes a timeline for implementing the policy.
  9. Carry out your plan to educate the public.
  10. Facilitate compliance via good signage, good communication, leadership support.
  11. Provide cessation support.

Other Key Requirements

Communication and education are the most important factors in successfully implementing a new smoke-free local regulation

Policies, Laws and Regulations

Local Government Regulations (county/municipal ordinances or Board of Health Rules)

Required Staffing (FTEs)

1 FTE; also need a part-time legal technical assistance

Special Funding

Funds for implementation (e.g. signage); a toll free number and/or a website for complaints as compliance is based on education and enforcement is complaint-driven; business and public educational materials; and resources to help tobacco users quit including counseling and evidence based tobacco cessation medications, such as nicotine replacement therapy are helpful, based on availability of funds

  • No smoking signs
  • Educational materials
  • Cessation materials
  • Compliance cards
  • Website and/or toll free line for reporting complaints

Training

Policy Development and community Organizing; knowledge of what constitutes an evidence based smoke-free law

Types of Staff

FTE requires a Master's in Public Health or equivalent experience, legal assistance requires a law degree valid in the jurisdiction

Return on Investment Details

  • Local Health Departments
  • Local Boards of Health
  • Voluntary health agencies (i.e., American Cancer Society, American Heart Association, and American Lung Association), local Health Departments, and health professionals are good places to start.
  • Ideally, coalitions will eventually include members who represent the diverse ethnic and cultural segments of the community and have a variety of skills, contacts, and experience. Support from the sectors of the community impacted by the ban is recommended, such as restaurants and bars, business leaders, etc.


Outcome Measures

Health outcome data (e.g. Emergency Department and/or Hospitalization Data related to heart attacks, asthma and respiratory disease)

Process Measures

  • Community and public support data
  • Business support
  • Pre and post air quality
  • Compliance data
  • BRFSS exposure of secondhand smoke in the workplace

Resources

Screen grab of Smoke-free & Tobacco-free Places webpage
Smoke-free & Tobacco-free Places
Resource - Website/webpage
Brought to you by Public Health Law Center
Screen grab of U.S. Tobacco Control Laws Database
U.S. Tobacco Control Laws Database
Tool - Data/mapping Tool
Brought to you by ANRF

 Related Topics


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Respiratory Diseases

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Tobacco Use

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Clean Air