title: Passing a smoke-free law in a pro-tobacco culture: a multiple streams approach.
abstract: 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.
authors.affiliation: Tobacco Policy Research Program, University of Kentucky College of Nursing, Lexington, Kentucky, USA.
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Greathouse
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Hahn
authors.forename: Chizimuzo T C
authors.initials: CT
authors.lastname: Okoli
authors.forename: Todd A
authors.initials: TA
authors.lastname: Warnick
authors.forename: Carol A
authors.initials: CA
authors.lastname: Riker
mesh_terms: D003469:Culture; D006801:Humans; D007629:Kentucky; D011050:Policy Making; D011057:Politics; D012907:Smoking / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution