Tobacco- and smoke-free policies are an effective strategy for reducing secondhand smoke exposure. These
policies can consist of voluntary business/organization policies, regulations from boards of health or other
health advisory organizations, and laws enacted by local governments. There is strong evidence that smoke-free
policies improve health by reducing heart attacks, asthma attacks, and hospitalizations, and other
outcomes; reduce secondhand smoke exposure, and reduce smoking.
While many tobacco- or smoke-free ordinances are enacted by state and local governments, rural communities may
also rely on businesses and organizations in the community to implement their own voluntary policies. Rural
program planners may consider working with community partners to implement tobacco-free policies in a range of
Examples of Smoke-Free Policies
On August 1, 2008, after seven years of advocacy, all public schools in North Carolina became 100%
tobacco-free. The policy prohibits use of any tobacco products by anyone, including staff, students,
and visitors on school grounds at all times. The North
Carolina Tobacco-Free Schools website provides information on assessing readiness as
well as adopting, implementing, and enforcing policies.
The Fresno Economic
Opportunities Commission Rural Tobacco Education Program provides presentations on
implementing smoke-free policies to housing owners, farmers markets, residents, and child care
providers, among many other groups in rural Fresno County, California. The Rural Tobacco Education
Program is funded by revenue resulting from the California Tobacco Health Protection Act of 1988,
which increased the state cigarette tax.
In January 2014, the Baker
City Council in rural Baker County, Oregon passed a law to make all Baker City parks
tobacco-free. This ordinance was championed by community members who expressed their support for creating
healthier public spaces, the Parks and Recreation Advisory Board, the Baker County Prevention Coalition, and
the local Tobacco Prevention and Education Program (TPEP). The TPEP conducted an observational assessment at
a park event six months after the law was enacted and reported high compliance with the tobacco-free
The North Dakota Center for Tobacco Prevention and
Control Policy (BreatheND) supported smoke-free policies at the state and local level.
The Center educated citizens on the health benefits of smoke-free air, which led to garnered support for
North Dakota's 2012 smoke-free law. The law prohibits smoking in enclosed public places and places of
employment. The Center also worked with the Public Health
Law Center to develop model
smoke-free policies for other spaces, such as multi-unit housing facilities, that local public
health units can adopt in communities across the state.
Considerations for Implementation
Rural program planners should consider state laws when developing local smoke-free ordinances.
State laws and
policies on tobacco can preempt local ordinances, board of health rules, and other types of local laws.
Preemption occurs when a higher level of government limits the authority of a lower level of government to
regulate a certain issue. Healthy
People 2030 objectives aim to eliminate state laws that preempt stronger local tobacco control laws.
Rural communities may need to consider their ability to enforce smoke-free policies. Smoke-free
policies should be communicated clearly through signage and documentation (for example, lease
agreements and employment contracts). Some organizations, including workplaces and schools, may
already have clear policies in place to enforce smoke-free policies through disciplinary actions.
However, these organizations may need to consider offering and promoting cessation services to
tobacco users in order to increase compliance with smoke-and tobacco-free policies.
that implement smoke-free policies in public spaces, such as parks, rely on the community members to
self-enforce these rules. In these cases, rural communities should ensure that “No Tobacco/No
Smoking” signs are clearly posted throughout public spaces. Rural communities may also choose to
promote awareness about new smoke-free ordinances through media campaigns and by connecting
community partners such as schools.
Program Clearinghouse Examples
Resources to Learn More
Americans for Nonsmokers' Rights
This website provides multiple resources for implementing a smoke-free air law in your community.
Resources include a readiness assessment, model ordinances, media opportunities, enforcement, and
Smoke-Free Laws Do Not Harm Business at
Restaurants and Bars
This fact sheet provides examples and evidence of outcomes of the passage of smoke-free laws in
various states and localities in the U.S. The evidence shows that smoke-free laws are important for
public health and do not negatively impact businesses.
Organization(s): Campaign for Tobacco-Free Kids
Smoke-Free Multifamily Housing
This website is the U.S. Department of Housing and Urban Development's (HUD) portal to various
Organization(s): HUD, American Academy of Pediatrics, American Lung Association, U.S.
Department of Health and Human Services
Policies Improve Health
This is a selection of scientific studies compiled by the CDC about smoke-free policies and their
effect on health. The studies include a section on the effect of smoke-free policies specifically on
hospitality workers, who are susceptible to unwanted secondhand smoke when their workplaces do not
ban smoking in and around their establishment. This selection of studies also covers specific health
outcomes including acute coronary events, asthma, and multiple outcomes.
Organization(s): Center for Disease Control and Prevention
This website provides multiple resources on creating and implementing smoke-free housing regulations
in various settings.
Organization(s): ChangeLab Solutions
Tobacco Dependence as a Standard of Care: A Health Systems Approach
This Health Systems Change Manual is part of Mission 100, an effort to disseminate Tobacco Prevention
and Control efforts in Alaska. It includes step-by-step guidelines for implementing smoke-free
policies in healthcare settings.
Organization(s): State of Alaska Department of Health and Social Services