Tobacco Induced Diseases (Mar 2018)
Comparative jurisdictional analysis of municipal smoke-free policies in Canada
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.
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