Political climate and smoke-free laws in rural communities: Views from elected officials and community advocates

The purpose was to determine factors associated with the political climate to enact smoke-free laws in rural communities. Health advocates in 30 rural Kentucky counties were interviewed using a 37-item questionnaire assessing their group's activities and resources and their elected officials' views on smoke-free policy. Elected officials from these counties were interviewed using a 35-item questionnaire assessing their views about smoke-free policy and contact with/influence over smoke-free policies. Advocates' and elected officials' responses were averaged to create county-level measures for each respondent type. Summary scores for dimensions of readiness for smoke-free policy (leadership, knowledge, community climate, existing policies, resources and political climate) were determined; the first 5 were based on advocate responses and political climate was based on elected official responses. Items with related content were compared between the two responder groups. Advocates' perception of support for a smoke-free law was positively related to elected officials' response to the likelihood of such a law passing in the next year. Controlling for population size and smoking rate, advocates' rating of the existing policies dimension (including smoke-free restaurants and manufacturing facilities) was associated with elected officials' view on the likelihood of a smoke-free law passing in the next year. Elected officials from rural communities with more voluntary smoke-free policies were more likely to report likelihood of smoke-free law enactment in the next year compared to those with fewer voluntary smoke-free policies. Rural health advocates can increase political readiness for smoke-free laws by working with public venues to voluntarily adopt smoke-free policies.