An Association Between State Laws Limiting Local Control and Community Smoke-Free Indoor Air in the United States

This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the American Nonsmokers’ Rights Foundation. The primary outcome variable is the presence of a “100% smoke-free policy,” across any of 4 indoor s...

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Published in:	Journal of primary care & community health Vol. 15; p. 21501319241280905
Main Authors:	Azagba, Sunday, Ebling, Todd, Korkmaz, Alperen, King Jensen, Jessica, Qeadan, Fares, Hall, Mark
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 01.01.2024 SAGE PUBLICATIONS, INC SAGE Publishing
Subjects:	Air Pollution, Indoor - legislation & jurisprudence Air Pollution, Indoor - prevention & control Bans Bars Cities Community health care Decision making Games Humans Law Local Government Nonsmokers Original Primary care Public health Restaurants Restaurants - legislation & jurisprudence Smoke-Free Policy - legislation & jurisprudence Smoking Sociodemographics State Government State laws Structural equation modeling Tobacco Tobacco Smoke Pollution - legislation & jurisprudence Tobacco Smoke Pollution - prevention & control United States Workplace - legislation & jurisprudence Workplaces United States limiting local communities community health smoking health promotion smoke-free indoor policies prevention preemption laws
ISSN:	2150-1319, 2150-1327, 2150-1327
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Abstract	This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the American Nonsmokers’ Rights Foundation. The primary outcome variable is the presence of a “100% smoke-free policy,” across any of 4 indoor settings: workplaces, restaurants, bars, and gaming venues. We employed generalized structural equation modeling to investigate the relationship between state laws pre-empting smoke-free indoor air regulation and local adoption of policies requiring smoke-free air in any public venues, or for specific venues, adjusting for sociodemographic characteristics. Our findings reveal a significant association between state preemption laws and the presence of a local 100% smoke-free indoor policy as of 2023. In states with preemption laws, cities were less likely to have a 100% smoke-free indoor policy at any venue than cities in states without preemption laws (OR = 0.07, 95% CI = 0.05-0.10). When considering specific smoke-free venues, cities in states with preemption laws were less likely to have a 100% smoke-free indoor policy covering workplaces (OR = 0.05, 95% CI = 0.03-0.09), restaurants (OR = 0.04, 95% CI = 0.02-0.07), bars (OR = 0.04, 95% CI = 0.03-0.08), and gaming venues (OR = 0.03, 95% CI = 0.01-0.09) compared to cities in states without preemption laws. Our study suggests that state preemption laws limit local decision-making and the implementation of public health policies focused on tobacco harms.
AbstractList	This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the American Nonsmokers’ Rights Foundation. The primary outcome variable is the presence of a “100% smoke-free policy,” across any of 4 indoor settings: workplaces, restaurants, bars, and gaming venues. We employed generalized structural equation modeling to investigate the relationship between state laws pre-empting smoke-free indoor air regulation and local adoption of policies requiring smoke-free air in any public venues, or for specific venues, adjusting for sociodemographic characteristics. Our findings reveal a significant association between state preemption laws and the presence of a local 100% smoke-free indoor policy as of 2023. In states with preemption laws, cities were less likely to have a 100% smoke-free indoor policy at any venue than cities in states without preemption laws (OR = 0.07, 95% CI = 0.05-0.10). When considering specific smoke-free venues, cities in states with preemption laws were less likely to have a 100% smoke-free indoor policy covering workplaces (OR = 0.05, 95% CI = 0.03-0.09), restaurants (OR = 0.04, 95% CI = 0.02-0.07), bars (OR = 0.04, 95% CI = 0.03-0.08), and gaming venues (OR = 0.03, 95% CI = 0.01-0.09) compared to cities in states without preemption laws. Our study suggests that state preemption laws limit local decision-making and the implementation of public health policies focused on tobacco harms. This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the American Nonsmokers' Rights Foundation. The primary outcome variable is the presence of a "100% smoke-free policy," across any of 4 indoor settings: workplaces, restaurants, bars, and gaming venues. We employed generalized structural equation modeling to investigate the relationship between state laws pre-empting smoke-free indoor air regulation and local adoption of policies requiring smoke-free air in any public venues, or for specific venues, adjusting for sociodemographic characteristics. Our findings reveal a significant association between state preemption laws and the presence of a local 100% smoke-free indoor policy as of 2023. In states with preemption laws, cities were less likely to have a 100% smoke-free indoor policy at any venue than cities in states without preemption laws (OR = 0.07, 95% CI = 0.05-0.10). When considering specific smoke-free venues, cities in states with preemption laws were less likely to have a 100% smoke-free indoor policy covering workplaces (OR = 0.05, 95% CI = 0.03-0.09), restaurants (OR = 0.04, 95% CI = 0.02-0.07), bars (OR = 0.04, 95% CI = 0.03-0.08), and gaming venues (OR = 0.03, 95% CI = 0.01-0.09) compared to cities in states without preemption laws. Our study suggests that state preemption laws limit local decision-making and the implementation of public health policies focused on tobacco harms.This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the American Nonsmokers' Rights Foundation. The primary outcome variable is the presence of a "100% smoke-free policy," across any of 4 indoor settings: workplaces, restaurants, bars, and gaming venues. We employed generalized structural equation modeling to investigate the relationship between state laws pre-empting smoke-free indoor air regulation and local adoption of policies requiring smoke-free air in any public venues, or for specific venues, adjusting for sociodemographic characteristics. Our findings reveal a significant association between state preemption laws and the presence of a local 100% smoke-free indoor policy as of 2023. In states with preemption laws, cities were less likely to have a 100% smoke-free indoor policy at any venue than cities in states without preemption laws (OR = 0.07, 95% CI = 0.05-0.10). When considering specific smoke-free venues, cities in states with preemption laws were less likely to have a 100% smoke-free indoor policy covering workplaces (OR = 0.05, 95% CI = 0.03-0.09), restaurants (OR = 0.04, 95% CI = 0.02-0.07), bars (OR = 0.04, 95% CI = 0.03-0.08), and gaming venues (OR = 0.03, 95% CI = 0.01-0.09) compared to cities in states without preemption laws. Our study suggests that state preemption laws limit local decision-making and the implementation of public health policies focused on tobacco harms.
Author	Hall, Mark Korkmaz, Alperen Azagba, Sunday Ebling, Todd Qeadan, Fares King Jensen, Jessica
AuthorAffiliation	3 Loyola University Chicago, Maywood, IL, USA 2 Rutgers Center for Tobacco Studies and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA 1 Pennsylvania State University, University Park, PA, USA 4 Wake Forest School of Medicine, Winston-Salem, NC, USA
AuthorAffiliation_xml	– name: 4 Wake Forest School of Medicine, Winston-Salem, NC, USA – name: 2 Rutgers Center for Tobacco Studies and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA – name: 3 Loyola University Chicago, Maywood, IL, USA – name: 1 Pennsylvania State University, University Park, PA, USA
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Keywords	limiting local communities community health smoking health promotion smoke-free indoor policies prevention preemption laws
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Snippet	This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the...
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SubjectTerms	Air Pollution, Indoor - legislation & jurisprudence Air Pollution, Indoor - prevention & control Bans Bars Cities Community health care Decision making Games Humans Law Local Government Nonsmokers Original Primary care Public health Restaurants Restaurants - legislation & jurisprudence Smoke-Free Policy - legislation & jurisprudence Smoking Sociodemographics State Government State laws Structural equation modeling Tobacco Tobacco Smoke Pollution - legislation & jurisprudence Tobacco Smoke Pollution - prevention & control United States Workplace - legislation & jurisprudence Workplaces
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Title	An Association Between State Laws Limiting Local Control and Community Smoke-Free Indoor Air in the United States
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