Description
Municipal codes play an important role in the broader context of tobacco control efforts because they complement state and federal efforts to reduce tobacco smoke exposure, reduce tobacco product pollution, and protect nonsmokers. This study examined smoking ordinances in nineteen communities in San Diego County and explored the association between the strictness of smoking policy, compliance and enforcement efforts, and smoking behavior. In part 1, archival data were utilized to compare municipal codes and characterize municipalities by the restrictiveness of their smoking ordinances. In part 2, archival data were obtained from city governments about code enforcement and compliance efforts to examine local government efforts to implement and enforce policies. In part 3, the study utilized a quasi-experimental design with repeated measurements, comparing communities with more and less stringent tobacco policies with respect to cigarette butt litter and the quantity and location of smoke-free signage posted in 32 recreational parks throughout 8 municipalities across the County of San Diego. A series of negative binomial regression models tested the relationship between cigarette butt count and restrictiveness of the smoking ordinances, compliance efforts, enforcement efforts, and median household income. The first model tested median household income with respect to cigarette butt counts. Municipalities with higher median household incomes had significantly lower cigarette butt counts than those with lower median household incomes (IRR = .9494; p < .001). The second model, which added the restrictiveness of municipality variable was not found to be significant. The final model tested all variables with respect to cigarette butt counts. Compared to less restrictive municipalities, more restrictive municipalities had significantly less cigarette butt counts (IRR = .7336; p < .001). Municipalities with more resources allocated towards tobacco control efforts had significantly more cigarette butt counts than those with fewer resources allocated (IRR = 1.0713; p < .001). Municipalities with more enforcement efforts had significantly more cigarette butt counts than those with less enforcement efforts (IRR = 1.1281; p = .046). Findings suggest that municipalities may benefit from adopting restrictive smoking ordinances, allocating resources towards implementation and enforcement, and educating the public on the harms of tobacco smoke exposure.
