Gregory Jackson Tung1, Jon S Vernick, Elizabeth A Stuart, Daniel W Webster. 1. 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.
Abstract
OBJECTIVES: 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.
OBJECTIVES: 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.
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