Diffusion of Philadelphia's no-smoking policy to Chinese businesses

Problem/Objective: Studies have shown that smoking policies are self-enforcing with high compliance levels, decreased levels of secondhand exposure amongst both workers and patrons, and have had little economic impact on restaurant employment, income, and patronage. These studies, however, have not examined the dissemination of policies to certain sub-populations. Specifically, these policies may ineffectively diffuse to Asian American communities due to social, cultural, and linguistic barriers that have historically impeded access to health care. Methods: Face-to-face interviews were conducted with Chinese merchants in the Philadelphia area. This research, guided by conceptual models of Diffusion of Innovations Theory and Theory of Reasoned Action/Planned Behavior, determined whether the new Philadelphia no-smoking policy has adequately diffused to Chinese-owned/operated businesses, as well as behavior intentions, level of adoption, and ways to enforce implementation. Results: Sources of policy information, particularly from the media, reflect gaps in awareness and/or barriers to actual enforcement due to existing social norms. These findings help determine whether barriers are preventing full protection of workers and customers from secondhand smoke, and provide recommendations to policy makers on culturally appropriate approaches for enforcement of the no-smoking law. Discussion: This study will give insight into the nature and content of recommendations to improve diffusion of official no-smoking policies to Chinese business owners and communities. This is particularly critical because a large majority of Asians, including Chinese in the Philadelphia metropolitan area and the neighboring states, is comprised of new immigrants who originate in countries where smoking is socially acceptable and culturally embedded.