Tobacco control policies and particularly those associated with environmental tobacco smoke (ETS) tend to originate in urban centers and diffuse out to smaller communities. Previous work by these investigators has shown a substantial time lag in ETS policy adoption between urban and rural communities. Even when policies are adopted by smaller communities, there are significant differences in bylaw strength and comprehensiveness, leading to disparity in population protection from ETS. While public health advocates press for movement toward the standards set by urban neighbours, it is not clear this will happen. Based on data from a case study of ETS policy initiation in one Canadian province, we suggest the gap in policy strength and comprehensiveness between urban and rural communities will remain. This case study involved stakeholder interviews, document reviews and a public opinion survey in two small communities (population 6,000, agricultural based, equidistant from large urban centers and within the same health and educational jurisdictions). The towns instituted very different ETS bylaws in 1995, one more comprehensive than the other. Neither has moved to strengthen those bylaws however nor do they seem to be under pressure to do so. We suggest a number of reasons that may account for this: difference in policy environments between large and small communities, difficulties in bylaw enforcement, higher smoking rates which may constrain public support and greater tolerance for "deviant" behaviour. Lessons for policy advocates will be discussed.
Learning Objectives: 1. Identify factors affecting policy development in rural settings 2. Analyze the relative importance of various factors affecting policy development 3. Name three methods for analyzing the policy development process
Keywords: Rural Communities, Tobacco Control
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA