Monitoring and targeting policy improvement utilizing a novel sub-county tobacco policy surveillance system

Many states are successful in curbing indoor smoking via state law, yet opportunities exist to further limit exposure via local policy. We designed a policy surveillance system focused on local parks and post-secondary institutions in Seattle King County.

Policies were collected from all 39 local cities, through online municipal codes or city officials. Public college policies were available online. 31/40 institutions were included; smaller institutions excluded with over-sampled in areas of tobacco disparities. Policy variables were identified, codebooks were developed and each policy was coded with inter-rater reliability analysis. Variables were selected for visual display and mapping.

We found variation among local policies in both datasets. While most post-secondary students are covered by some policy, a wide range of prohibitions exist. Few are 100% smoking free and significant exceptions exist. Nearly half of institutions have no policies. For parks, 12/39 cities had policies in 2013 (up from 5 in 2010). Five in South King County (highest disparities area) had no policies for parks or no policies for some. Four cities prohibited all smoking in 100% of parks in 2013 (up from 0 in 2010).

Although time and labor-intensive, rigorous policy surveillance methods are needed locally so that laws are written optimally and to discover/eliminate disparities. Significant room for improvement exists in tobacco policy across King County parks and post-secondary institutions; findings can shape/direct health department activities. Use of open source systems creates efficiencies for regular benchmarking of policy over time.