No abstract

Hospitality workers demonstrated significant declines in hair nicotine and respiratory symptoms after the law. Comprehensive smoke-free laws can provide the greatest protection to bar workers who are the most vulnerable to SHS exposure at work.

Purpose-This study aimed to: (a) describe the Strength of Tobacco Control (SoTC) capacity, efforts and resources in rural communities, and (b) examine the relationships between SoTC scores and sociodemographic, political and health-ranking variables.Methods-Data were collected during the baseline pre-intervention phase of a community-based randomized, controlled trial. Rural counties were selected using stratified random sampling (n = 39). Key informant interviews were employed. The SoTC, originally developed and tested with states, was adapted to a county-level measure assessing capacity, efforts, and resources. Univariate analysis and bivariate correlations assessed the SoTC total score and construct scores, as well as their relationships. Multiple regression examined the relationships of county-level sociodemographic, political and health-ranking variables with SoTC total and construct scores.Findings-County population size was positively correlated with capacity (r = 0.44; P < .01), efforts (r = 0.54; P = .01) and SoTC total score (r = 0.51; P < .01). Communities with more resources for tobacco control had better overall county health rankings (r = .43; P < .01). With population size, percent Caucasian, tobacco production, and smoking prevalence as potential predictors of SoTC total score, only population size was significant.Conclusions-SoTC scores may be useful in determining local tobacco control efforts and appropriate planning for additional public health interventions and resources. Larger rural communities were more likely to have strong tobacco control programs than smaller communities. Smaller rural communities may need to be targeted for training and technical assistance. Leadership development and allocation of resources are needed in all rural communities to address disparities in tobacco use and tobacco control policies. in urban areas.1 , 3 -5 Furthermore, those living in rural communities are more likely to be exposed to secondhand smoke than those living in urban areas.6 KeywordsDespite the fact that smoke-free and other tobacco control laws are gaining popularity in the United States and globally, rural communities have fewer smoke-free laws and voluntary restrictions than do their urban counterparts.6 , 7 Further, smaller towns are less likely than larger ones to enact smoke-free policies.8 , 9 As efforts to enact smoke-free laws and other tobacco control policies increase, assessing local efforts, capacity and resources for tobacco control grows more important, especially in rural, underserved communities that may be late in adopting these laws.Mobilizing local communities to enact tobacco control policies is recommended in the Centers for Disease Control and Prevention's (CDC) community-based model for tobacco control.10 The premise of the model, currently implemented in several states, is to promote policy development at both local and state levels to change social norms related to tobacco control.The Strength of Tobacco Control (SoTC) instrument was initially developed to evalua...

The Community Readiness Model is appropriate for understanding local policy development, and it provides advocates with information that may prove helpful in advancing smoke-free policy.