title: Smoke-free policy implementation: theoretical and practical considerations.
abstract: Secondhand smoke exposure is a major public health issue, increasing the risk of cardiovascular and respiratory diseases and cancer. Although best practices for adopting smoke-free policy are well understood, there is limited research on the effective implementation of smoke-free policy. This article presents theoretical and practical considerations for smoke-free policy implementation in three Kentucky communities guided by the Institutional Analysis and Development (IAD) Framework. Although both Danville and Lexington-Fayette County, Kentucky have comprehensive smoke-free policies, Danville had more effective implementation, as well as better outcomes. Further study is needed to understand the critical elements of smoke-free policy implementation and their association with population outcomes. The IAD is a promising model to guide the study of both policy adoption and implementation.
authors.affiliation: Tobacco Policy Research Program, University of Kentucky, Lexington, KY, USA atfall2@uky.edu.
authors.forename: Amanda
authors.initials: A
authors.lastname: Fallin
authors.affiliation: Institute for Pharmaceutical Outcomes and Policy, University of Kentucky, Lexington, KY, USA.
authors.forename: Amie
authors.initials: A
authors.lastname: Goodin
authors.affiliation: Tobacco Policy Research Program, University of Kentucky, Lexington, KY, USA.
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Rayens
authors.affiliation: College of Nursing, University of Kentucky, Lexington, KY, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Morris
authors.affiliation: College of Nursing, University of Kentucky, Lexington, KY, USA.
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Hahn
mesh_terms: D005260:Female; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D007629:Kentucky; D008297:Male; D011050:Policy Making; D015397:Program Evaluation; D011634:Public Health; D012040:Regional Health Planning / Q000458:organization & administration*; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Institutional Analysis and Development Framework; policy implementation; smoke-free policy