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. The Community Preventive Services Task Force has found strong evidence that smoke-free policies improve health by reducing secondhand smoke exposure, reducing heart attacks, reducing asthma attacks and hospitalizations, and may reduce sudden infant death syndrome (SIDS) and low birthweight births.
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 settings, including:
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 ordinance.
- 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 2020 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.
Many communities 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 with community partners such as schools.
Program Clearinghouse Examples
- Southern Coalfields Tobacco Prevention Network
- North Dakota Center for Tobacco Prevention and Control Policy
- Alaska Tobacco Prevention and Control Program
- National Native Network
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 implementation information.
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 smoke-free toolkits.
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
Smokefree Multi-Unit Housing
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