Comparative jurisdictional analysis of municipal smoke-free policies in Canada
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1
BC Women's Hospital + Health Centre, Canada
2
Simon Fraser University, Faculty of Health Sciences, Canada
3
University of Kentucky, College of Nursing, United States of America
4
Centre of Excellence for Women's Health, Canada
5
University of British Columbia’s Okanagan Campus, Canada
6
Institute for Healthy Living and Chronic Disease Prevention, Canada
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A24
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ABSTRACT
Background:
The growing adoption of outdoor smoke-free policies globally
has endorsed a new area of tobacco control policy research. This study compares the development, adoption,
and implementation of outdoor smoke-free bylaws in city parks and recreational
areas within jurisdictions in British Columbia, Canada. This study combines theoretical
policy analysis with data on policy implementation to inform discussions on
alternative approaches to outdoor smoke-free policy.
Methods:
This is a mixed methods comparative case study of three
Canadian municipalities, informed by Kingdon's concept of policy spillover,
Weimer's discussion of policy discourse, Sabatier's Advocacy Coalition
Framework (ACF) and Mahoney at al.'s equity-focused health impact assessment. Key informant interviews (n=20) and policy
documents were used to generate a historical narrative of each jurisdictions'
policy development process, and a thematic analysis of these data was conducted
to identify dominant frames used to support the smoke-free policy in each
setting. Particular attention was paid to discourses of evidence, equity and ethics--three
theoretical constructs from the policy literature.
Results:
Health, environmental and social concerns informed the
introduction of the smoke-free policies, but the emphasis on each factor differed
for historical, practical, and political reasons. Despite some uncertainty of
the health effects of outdoor SHS exposure, health issues were the most salient.
Equity concerns differed as well. Whereas there is little evidence equity
issues were a concern in Vancouver, equity was a more prominent theme in the
other jurisdictions.
Conclusions:
This comparative policy analysis suggests that to be accepted,
smoke-free policies should be tailored to the features of a particular setting.
Documenting these variations can help guide tobacco control advocates to
develop equitable policies, and inform the translation of tobacco control
science into policy while using innovative equity focused tools to assess
policy impact.