Political factors affecting the enactment of state-level clean indoor air laws.
OBJECTIVE
We examined the effects of key political institutional factors on the advancement of state-level clean indoor air laws.


METHODS
We performed an observational study of state-level clean indoor air law enactment among all 50 US states from 1993 to 2010 by using extended Cox hazard models to assess risk of enacting a relevant law.


RESULTS
During the 18-year period from 1993 to 2010, 28 states passed a law covering workplaces, 33 states passed a law covering restaurants, 29 states passed a law covering bars, and 16 states passed a law covering gaming facilities. States with term limits had a 2.15 times greater hazard (95% confidence interval [CI] = 1.27, 3.65; P = .005) of enacting clean indoor air laws. The presence of state-level preemption of local clean indoor air laws was associated with a 3.26 times greater hazard (95% CI = 1.11, 9.53; P = .031) of state-level policy enactment. In the presence of preemption, increased legislative professionalism was strongly associated (hazard ratio = 3.28; 95% CI = 1.10, 9.75; P = .033) with clean indoor air law enactment.


CONCLUSIONS
Political institutional factors do influence state-level clean indoor air law enactment and may be relevant to other public health policy areas.
Gregory J. Tung is with the Pediatric Injury Prevention, Education, and Research Program and the Department of Health Systems, Management, and Policy at the Colorado School of Public Health, Aurora. Jon S. Vernick and Daniel W. Webster are with the Department of Health Policy and Management, and Elizabeth A. Stuart is with the departments of Mental Health and Biostatistics at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Gregory Jackson
GJ
Tung
Jon S
JS
Vernick
Elizabeth A
EA
Stuart
Daniel W
DW
Webster
D016902:Air Pollution, Indoor / Q000331:legislation & jurisprudence*; D006801:Humans; D011057:Politics; D016016:Proportional Hazards Models; D012147:Restaurants / Q000331:legislation & jurisprudence; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence; D013219:State Government; D014481:United States; D017132:Workplace / Q000331:legislation & jurisprudence