Science, prudence, and politics: the case of smoke-free indoor spaces.
OBJECTIVE
We examine the process of how epidemiologic evidence regarding the harms of secondhand smoke (SHS) exposure has been translated into policy and distill lessons that could be applied to other public health areas.


METHODS
We detail the history of the growth of evidence and the development of prudent policies in this area and the parallel, organized efforts led by the tobacco industry to oppose them. We also describe how opposition to these policies helped shape the emerging research agenda.


RESULTS
Seven lessons emerged from our study. (i) Even after a policy goal has been achieved, the need for epidemiological evidence and inquiry remains. (ii) Dissemination and implementation research is necessary. (iii) The best and most necessary research questions do not always come from epidemiologists. (iv) There is a need for epidemiologists to work with other researchers across disciplines. (v) Epidemiologists must anticipate the opposition. (vi) Focused, well-organized advocacy is needed to translate even the strongest epidemiological evidence into policy change. (vii) Epidemiologists should be trained to engage and interact with public health advocates, practitioners, and policy makers.


CONCLUSIONS
Although this case study shows that policy can be driven by science, it also demonstrates that clear scientific evidence does not automatically lead to optimal policy.
Widome
Rachel
R
Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis Veterans Affairs Medical Center, Minneapolis, MN 55417, USA. chel@umn.edu
Samet
Jonathan M
JM
Hiatt
Robert A
RA
Luke
Douglas A
DA
Orleans
C Tracy
CT
Ponkshe
Prabhu
P
Hyland
Andrew
A
D016902:Air Pollution, Indoor / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D003657:Decision Making; D055317:Evidence-Based Practice; D006291:Health Policy; D006801:Humans; D033181:Information Dissemination; D009518:New York / Q000453:epidemiology; D011057:Politics; D015980:Public Health Practice; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000331:legislation & jurisprudence*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D057170:Translational Research, Biomedical; D014481:United States / Q000453:epidemiology
D014028:Tobacco Smoke Pollution