142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Politics, Policies and Health Behaviors: The Case of Tobacco

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 1:10 PM - 1:30 PM

Ashley Fox, PhD, MA , Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, NY
Rakesh Yumkham, MPH
Though believed to be important, in practice politics is frequently neglected as a “fundamental cause” of health outcomes. While anti-smoking policies are widely viewed as a public health success case, so-called “red” states (Southern/Midwestern states that vote Republican) generally have higher smoking rates than “blue” states (states in the Northeast/West Coast that vote Democratic). This disparity is typically explained by differences in demographic characteristics (red-states are poorer than blue-states). However, the relationship between state political climate and health  may operate through policy mechanisms. We assess how state political context affects the adoption of two tobacco policies and declines in smoking rates using state-level data over a fifteen-year period (1996-2011). A longitudinal dataset was constructed from publicly available data of cigarette excise taxes, indoor smoking policies, state smoking prevalence and demographic characteristics from 1996 to 2011. Political context was measured as state vote share for Republican or Democratic presidential candidates and a validated measure of state political culture. Using repeat measure GEE, we assess the relationship between state political context and state smoking prevalence adjusting for demographic characteristics and state policies. We find that state political culture/climate predicts both cigarette excise taxes and indoor smoking restrictions and that more conservative states have seen lower declines in smoking prevalence but that this relationship is only partly explained by state smoking policies. After adjusting for demographic characteristics, state political climate affects smoking behaviors both indirectly (through policy) and directly (a portion of variation that cannot be explained with reference to specific policies).

Learning Areas:

Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Evaluate the effect of political climate on smoking policies and behaviors Compare anti-smoking policies and rates of smoking decline between states with different political climates. Assess the direct and indirect impact of politics on smoking outcomes.

Keyword(s): Tobacco Use, Politics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am interdisciplinary scholar in public health and political science whose research focuses on the intersections of politics, policy and health outcomes. I contributed to the design and analysis of this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.