To assess the key components of smoke-free campaigns that may have influenced voting outcomes in three communities.
Design.
Community case studies with content analysis of tobacco-related newspaper articles.
Setting.
Three semiurban Missouri communities.
Subjects.
One hundred eighty-one articles referencing tobacco published during the campaigns and five key informant interviews.
Measures.
Articles were coded for type, community referenced, tobacco control position, source of quotations, use of evidence, and frame. Semistructured interviews with key informants collected additional information.
Analysis.
Descriptive statistics were utilized to examine media coverage in each community. Key themes and events for each campaign were identified from qualitative interviews.
Results.
The only community that failed to pass its initiative had the highest proportion of letters to the editor (81.1%), anti–tobacco control articles (34.2%), use of a rights frame (28.8%), no evidence used (36.9%), no neighboring communities with policies, strong Tea Party presence, and no support from the chamber of commerce. Across all communities, more articles incorporating health frames were pro–tobacco control (70.7%) and more articles with a rights frame were anti–tobacco control (62.0%), compared to other positions.
Conclusion.
Several factors can influence the policy process. Tobacco control policy advocates facing strong opposition should consider the many factors (demographics, proximity to other adopting localities, politics) driving the debate and use media as an avenue to influence the discussion, connect with the public and policymakers, and mobilize proponents.
BrennanPBufflerPAReynoldsP. Secondhand smoke exposure in adulthood and risk of lung cancer among never smokers: A pooled analysis of two large studies. Int J Cancer. 2004;109:125–131.
2.
HeJVupputuriSAllenK. Passive smoking and the risk of coronary heart disease—a meta-analysis of epidemiologic studies. N Engl J Med.1999;340:920–926.
3.
OtsukaRWatanabeHHirataK. Acute effects of passive smoking on the coronary circulation in healthy young adults. JAMA. 2001;286:436–441.
4.
PitsavosCPanagiotakosDBChrysohoouC. Association between exposure to environmental tobacco smoke and the development of acute coronary syndromes: The CARDIO2000 case–control study. Tob Control. 2002;11:220–225.
5.
SturmJJYeattsKLoomisD. Effects of tobacco smoke exposure on asthma prevalence and medical care use in North Carolina middle school children. Am J Public Health. 2004;94:308–313.
6.
US Dept of Health and Human Services.The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, Ga: US Dept of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006.
7.
ÖbergMJaakkolaMSWoodwardA. Worldwide burden of disease from exposure to second-hand smoke: A retrospective analysis of data from 192 countries. Lancet. 2011;377:139–146.
8.
PickettMSSchoberSEBrodyDJ. Smoke-free laws and secondhand smoke exposure in US non-smoking adults, 1999–2002. Tob Control. 2006;15:302–307.
9.
WisotzkyMAlbuquerqueMPechacekTFParkBZ. The National Tobacco Control Program: Focusing on policy to broaden impact. Public Health Rep.2004;119:303–310.
10.
GiovinoGABienerLHartmanAM. Monitoring the tobacco use epidemic I. Overview: Optimizing measurement to facilitate change. Prev Med.2009;48(1 suppl):S4–S10.
11.
BrownsonRCHaire-JoshuDLukeDA. Shaping the context of health: A review of environmental and policy approaches in the prevention of chronic diseases. Annu Rev Public Health. 2006;27:341–370.
12.
OngMKGlantzSA. Cardiovascular health and economic effects of smoke-free workplaces. Am J Med.2004;117:32–38.
13.
BarnoyaJArvizuMJonesMR. Secondhand smoke exposure in bars and restaurants in Guatemala City: Before and after smoking ban evaluation. Cancer Causes Control. 2011;22:151–156.
14.
BarnoyaJGlantzSA. Cardiovascular effects of secondhand smoke: Nearly as large as smoking. Circulation. 2005;111:2684–2698.
15.
BarnoyaJGlantzS. Association of the California tobacco control program with declines in lung cancer incidence. Cancer Causes Control. 2004;15:689–695.
16.
FarrellyMCNonnemakerJMChouR. Changes in hospitality workers' exposure to secondhand smoke following the implementation of New York's smoke-free law. Tob Control. 2005;14:236–241.
17.
PellJPHawSCobbeS. Smoke-free legislation and hospitalizations for acute coronary syndrome. N Engl J Med.2008;359:482–491.
18.
JemalACokkinidesVEShafeyOThunMJ. Lung cancer trends in young adults: An early indicator of progress in tobacco control (United States). Cancer Causes Control. 2003;14:579–585.
19.
Institute of Medicine.Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington, DC: National Academies Press; 2010.
20.
HahnEJRayensMKYorkN. Effects of a smoke-free law on hair nicotine and respiratory symptoms of restaurant and bar workers. J Occup Environ Med.2006;48:906–913.
21.
MenziesDNairAWilliamsonPA. Respiratory symptoms, pulmonary function, and markers of inflammation among bar workers before and after a legislative ban on smoking in public places. JAMA. 2006;296:1742–1748.
HylandAHigbeeCBorlandR. Attitudes and beliefs about secondhand smoke and smoke-free policies in four countries: Findings from the International Tobacco Control Four Country Survey. Nicotine Tob Res.2009;11:642–649.
24.
SkeerMGeorgeSHamiltonWL. Town-level characteristics and smoking policy adoption in Massachusetts: Are local restaurant smoking regulations fostering disparities in health protection?Am J Public Health. 2004;94:286–292.
25.
AhrensDUebelherPRemingtonPL. Evaluation of community and organizational characteristics of smoke-free ordinance campaigns in 15 Wisconsin cities. Prev Chronic Dis.2005;2:A08.
26.
OsypukTLAcevedo-GarciaD. Support for smoke-free policies: A nationwide analysis of immigrants, US-born, and other demographic groups, 1995–2002. Am J Public Health. 2010;100:171–181.
27.
SmithClegg KWakefieldMEdsallE. The good news about smoking: How do US newspapers cover tobacco issues?J Public Health Pol.2006;27:166–181.
28.
Centers for Disease Control and Prevention.Best Practices for Comprehensive Tobacco Control Programs—2007. Atlanta, Ga: US Dept of Health and Human Services; 2007.
29.
Campaign for Tobacco-Free Kids.Big Tobacco's Latest Dirty Trick: Deceiving Oregon Voters. Washington, DC: Campaign for Tobacco-Free Kids; 2007.
30.
Report summary: Missourians against tax abuse. Jefferson City, MO: Missouri Ethics Commission; 2006.
31.
Tobacco Tax: Money Watch. Sacramento, Calif: California HealthCare Foundation; 2007.
FarrellyMCNonnemakerJDavisKCHussinA. The influence of the National Truth Campaign on smoking initiation. Am J Prev Med.2009;36:379–384.
34.
NiederdeppeJFarrellyMCHavilandML. Confirming “truth”: More evidence of a successful tobacco countermarketing campaign in Florida. Am J Public Health. 2004;94:255–257.
35.
NiederdeppeJFarrellyMCWenterD. Media advocacy, tobacco control policy change and teen smoking in Florida. Tob Control. 2007;16:47–52.
36.
ZazaSBrissPAHarrisKW, Task Force on Community Preventive Services, Centers for Disease Control and Prevention, US Dept of Health and Human Services, eds. The Guide to Community Preventive Services. New York, NY: Oxford University Press; 2005.
37.
Centers for Disease Control and Prevention.State Tobacco Activities Tracking and Evaluation (STATE) System. Available at: http://www.cdc.gov/tobacco/statesystem. Accessed March 5, 2012.
38.
HarrisJKGeremakisCMoreland-RussellS. Demographic and geographic differences in exposure to secondhand smoke in Missouri workplaces, 2007–2008. Prev Chronic Dis.2011;8:A135.
MenasheCLSiegelM. The power of a frame: An analysis of newspaper coverage of tobacco issues—United States, 1985–1996. J Health Commun. 1998;3:307–325.
42.
SmithClegg KTerry-McElrathYWakefieldMDurrantR. Media advocacy and newspaper coverage of tobacco issues: A comparative analysis of 1 year's print news in the United States and Australia. Nicotine Tob Res.2005;7:289–299.
43.
HelmeDWBorlandRYoungW. The development and validation of a coding protocol to measure change in tobacco-control newspaper coverage. Health Promot Pract. 2006;7:103–109.
44.
Moreland-RussellSHarrisJKIsraelK. “Anti-smoking data are exaggerated” versus “the data are clear and indisputable”: Examining letters to the editor about tobacco. J Health Commun. 2012:1–17.
Prakop W.Protecting your health. Mid Rivers Newsmagazine. January 26, 2011:4.
47.
HarrisJKSheltonSCMoreland-RussellSLukeDA. Tobacco coverage in print media: The use of timing and themes by tobacco control supporters and opposition before a failed tobacco tax initiative. Tob Control. 2010;19:37–43.
