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Passing a Smoke-Free Law in a Pro-Tobacco Culture: A Multiple Streams Approach

Tobacco Policy Research Program, University of Kentucky College of Nursing, Lexington, Kentucky

Ellen J. Hahn, DNS, RN

Tobacco Policy Research Program, University of Kentucky Colleges of Nursing and Public Health, Lexington, Kentucky

Chizimuzo T. C. Okoli, MSN, RN

Tobacco Policy Research Program, University of Kentucky College of Nursing, Lexington, Kentucky

Todd A. Warnick, MA, MHA, CADC

Bluegrass Mental Health and Mental Retardation Board, Inc., Richmond, Kentucky

Carol A. Riker, MSN, RN

University of Kentucky College of Nursing, Lexington, Kentucky

This article describes a case study of the policy development and political decision-making process involved in the enactment of Lexington, Kentucky’s smoke-free law. The multiple streams framework is used to analyze the development of the law in a seemingly unlikely and challenging political environment. Proponents developed a dissemination research plan targeted at policy makers and the public to demonstrate the need for a comprehensive law. The existence of a strong coalition of health care providers and health care systems including the board of health, as well as long-standing tobacco control expertise and a strong legal team, were essential ingredients for success. A deliberate strategy to expose the tobacco industry was effective in preparing policy makers for the opponents’ policy arguments. As expected, a hospitality industry association was formed to oppose the ordinance, resulting in a legal challenge that delayed enactment of the law.

Key Words: secondhand smoke • policy development • tobacco policy • no-smoking laws

Policy, Politics, & Nursing Practice, Vol. 6, No. 3, 211-220 (2005)
DOI: 10.1177/1527154405278775


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