Enacting Tobacco Control Policies: Do Behavioral Science Theories Help Explain Legislators' Voting Behavior?

Introduction: Legislator voting behavior is important to public health. We systematically review existing research to explore the use of behavioral science theories to better understand the voting behavior of legislators related to tobacco control issues. Research Question: Do behavioral science theories such as the Theory of Planned Behavior provide useful insights into legislator voting behavior? Methods: We identified relevant tobacco control research in online databases and identified studies that examined determinants of legislator voting behavior in a public health context. To be included, studies had to be: 1) focused on tobacco-related voting behavior; 2), empirically-based; 3) based in a democracy; 4) in English; and 5) identify specific determinants of voting practices. Results: 12 articles met our inclusion criteria. Four papers were specifically grounded in behavioral science theory. These articles all used the Theory of Planned Behavior and the theory's core constructs of attitude, social norms, and perceived behavioral control. Determinants examined by the 8 papers not explicitly grounded in behavior science theory also fit well with the core constructs of the Theory of Planned Behavior. Legislators who believed that government has a role in influencing smoking behavior, believed that smoking was a serious health problem, and perceived normative pressure from constituents or other policy makers were more likely to support tobacco control measures. Conclusion: Behavioral science theories such as the Theory of Planned Behavior can be used to understand legislator voting behavior and may be useful to health advocates in the advancement of tobacco control and other health policies.